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Table of Contents

General Principles of Pharmacology Introduction Practice Questions Content Pharmacokinetics Practice Questions Content Videos Pharmacodynamics Practice Questions Content Autonomic Pharmacology Introduction Practice Questions Content Videos Adrenergic Pharmacology Practice Questions Content Videos Cholinergic Pharmacology Practice Questions Content Videos Antihypertensives Practice Questions Content Videos Antiarrhythmics Practice Questions Content Videos Antianginals Practice Questions Content Videos Congestive Heart Failure Drugs Practice Questions Content Videos Antilipidemics Practice Questions Content Videos Sedative-Hypnotics Practice Questions Content Videos Opioids Practice Questions Content Video General Anesthetics Practice Questions Content Local Anesthetics Practice Questions Content Videos Antipsychotics Practice Questions Content Antidepressants Practice Questions Content Videos AntiParkinsons Practice Questions Content Videos Antiseizure Practice Questions Content Neuromuscular Blockers Practice Questions Content Videos

Antihistamines/Bradykinins Practice Questions Content Serotonin Practice Questions Content Videos Ergot Alkaloids Practice Questions Content Videos Vasoactive Peptides Practice Questions Content Video Pulmonary Pharmacology Practice Questions Content Videos Diuretics Practice Questions Content Gastrointestinal Drugs Practice Questions Content Videos Adrenocorticoids Practice Questions Content Videos Diabetes Management Practice Questions Content Videos Thyroid Drugs Practice Questions Content Video Gonadal/Ovarian Agents Practice Questions Content Hypothalamic Drugs Practice Questions Content Videos Anticancer Practice Questions Content Videos Antibacterials Practice Questions Content Antivirals Practice Questions Content Videos Antifungals Practice Questions Content Videos Antiparasitics Practice Questions Content Anticoagulants Practice Questions Content Immunopharmacology: Immunosuppressants and Immunomodulators Practice Questions Content Anti-inflammatories Practice Questions Content Special Topics

 

Chapter 1: General Principles of Pharmacology--Introduction The Scope of Medical Pharmacology Drug Receptor Interactions Receptor Classes Covalent Drug-Receptor Interactions COX2 Inhibition by Aspirin Non-Covalent Drug-Receptor Interations Drug Shape and Chirality Racemates  Pharmacology Practice Questions:  General Principles Practice question set #1 (16 multiple choice questions (mcq)) Practice question set #2 (10 mcq) Practice question set #3 (9 matching) Practice question set #4 (13 mcq) Practice question set #5 (15 mcq) Practice question set #6 (15 mcq) Practice question set #7 (10 mcq) Practice question set #8 (10 mcq) Return to top of Page   Chapter 2:  Pharmacokinetics. Biotransformation, Transport Absorption Routes of Administration Bioavailability Pharmacokinetics Drug Metabolism Individual to Individual Differences in Responses to Drugs Genetic Factors Influencing Drug Metabolism Effects of Age on Responses to Drugs Drug-Drug interactions Pharmacokinetics and Some Anesthetics Agents  Pharmacology Practice Questions:  Pharmacokinetics, Biotransformation, Transport Practice question set #1 (General Questions) (10 multiple choice questions (mcq)) Practice question set #2 (Drug Metabolizing Systems) (5 mcq) Practice question set #3 (Drug Ionization and Transport) (25 mcq) Practice question set #4 (Drug Absorption and Biotransformation) (34 mcq) Practice question set #5 (Barbiturates and Benzodiazepines) (30 mcq) Practice question set #6 (Opioids and Sedative-Hypnotics) (26 mcq) Practice question set #7 (General Pharmacokinetics I) (10 mcq) Practice question set #8 (General Pharmacokinetics II) (11 mcq) Practice question set #9 (General Pharmacokinetics III) (10 mcq) Practice question set #10 (General Pharmacokinetics IV) (10 mcq) Practice question set #11 (General Pharmacokinetics V (Plasma Protein Binding)) (10 mcq) Practice question set #12 (General Pharmacokinetics VI (Bioavailability; Transport)) (12 mcq) Practice question set #13 (General Pharmacokinetics VI (Routes of Administration; Clearance)) (10 mcq) Practice question set #14 (General Pharmacokinetics (Absorption) VII) (10 mcq) Practice question set #15 (Drug Metabolism I) (10 mcq) Practice question set #16 (Drug Metabolism II) (11 mcq) Practice question set #17 (Drug Metabolism III) (10 mcq) Practice question set #18 (Drug Metabolism IV) (10 mcq) Practice question set #19 (Drug Metabolism V:  Genetic Polymorphism) (10 mcq) Practice question set #20 (Drug Metabolism VI:  Drug-Drug Interactions) (10 mcq) Practice question set #21 (Drug Metabolism VII) (10 mcq) Practice question set #22 (Drug Metabolism VIII: Flavin-Containing Monooxygenases (FMOs) and Epoxide Hydrolases (EH)) (10 mcq) Flashcards Problem set #1 (7 problems) Problem set #2 (7 mcq) Practice Exam #1 (20 mcq) Practice Exam #2 (21 mcq) Return to top of Page  Pharmacokinetics Videos: Pharmacokinetics Definitions (16 min) Absorption Overview (17 min) Lipophilic and Hydrophilic Drugs (6 min) Ion Trapping (3 min) Bioavailability (16 min) First Pass Metabolism (15 min) Volume of Distribution (Vd) (24 min) Drug Clearance:  Basic Concepts (11 min) Placental Drug Transfer (11 min) Renal Clearance (17 min) Drug Metabolism:  Phase I and Phase II (7 min / 8 min) Cytochrome P450 Enzyme System Inducers, Inhibitors and Isoforms (14 min) Midazolam for Seizure Management (4 min) Return to top of Page   Chapter 3:  Pharmacodynamics Drug-Receptor Interactions Signal Transduction Intracellular Receptors Drug Regulated Transmembrane Enzymes Cytokine Receptors Ligand-Gated Channels I G proteins and Second Messengers Receptor Desensitization Drug Concentration-Response Relationships Signaling Mechanisms and Drug Actions Transmembrane Sites of Action G protein Coupling Second Messenger Systems Nitric Oxide Catecholamine Refractoriness Return to top of Page  Pharmacology Practice Questions:  Pharmacodynamics Practice question set #1 (General Questions:  Receptor Activation and Inhibition) (12 multiple choice questions (mcq) Practice question set #2 (G Protein and Signal Transduction Systems) (9 mcq) Practice question set #3 (Drug receptor Agonists and Antagonists) (10 mcq) Practice question set #4 (General Pharmacology) (10 mcq) Practice question set #5 (G Protein and Signal Transduction Pathways) (10 mcq) Practice question set #6 (Pharmacodynamic Principles) (10 mcq) Practice question set #7 (Receptor Pharmacology) (10 mcq) Practice question set #8 (Membrane Transport Systems) (10 mcq) Practice question set #9 (Drug Resistance Mechanisms) (10 mcq) Practice question set #10 (Drug Metabolizing Systems:  Phase I and Phase II) (10 mcq) Practice question set #11 (Drug Metabolism:  Cytochrome p450) (10 mcq) Practice question set #12 (Drug Metabolism:  Cytochrome p450) (10 mcq) Practice question set #13 (Drug Metabolism: Phase II Reactions) (10 mcq) Practice question set #14 (Effects of Drugs on Drug Metabolism) (10 mcq) Practice question set #15 (Drug Toxicities) (10 mcq) Flashcards Practice Exam 1   (17 mcq) Unit Practice Exam #1 (13 mcq) Unit Practice Exam #2 (17 mcq) Unit Practice Exam #3 (20 mcq) Unit Practice Exam #4 (21 mcq) Return to top of Page   Chapter 4: Pharmacology of the Autonomic Nervous System:  Introduction: Autonomic Nervous System (ANS) Anatomy Comparison between Sympathetic and Parasympathetic Nerves Sympathetic Nervous System Parasympathetic Nervous System:  Cranial-Sacral Outflow ANS Neurotransmitters:  Effector Organs Characteristics of Autonomic Organ Innervation "Fight or Flight" ANS Responses ANS Neurotransmission Neurotransmitter Criteria Neurotransmitter Steps Cholinergic Neurotransmission Transmitter Synthesis and Degradation Acetylcholinesterase Acetylcholine Storage and Release Cholinergic Transmission:  Site Differences Cholinergic Transmission:  Signal Transduction Catecholamine Synthetic Pathway Adrenergic Neurotransmission:  Introduction to the Neurotransmitters Catecholamine Synthesis, Storage, and Release Catecholamine Reuptake Adrenergic Receptor Subtypes Other Autonomic Neurotransmitters/Co-transmitters Predominant Sympathetic or Parasynpathic Tone:  Anatomical Sites Baroreflexes Drug Modification of Autonomic Function Autonomic Dysfunction Return to top of Page   Pharmacology Practice Questions:  Introduction to Autonomic Pharmacology Practice Question Set #1 (20 multiple choice questions (mcq)) Practice Question Set #2 (17 mcq) Practice Question Set #3 (15 mcq) Practice Question Set #4 (15 mcq) Return to top of Page Introduction Videos Thoracolumbar Sympathetic Nervous System (5 min) Introduction to Autonomic Pharmacology (18 min) Autonomic Regulation of Heart Rate (5 min) Anatomy:  Parasympathetic Nervous System (6 min) Pre-Capillary Sphincter Regulation (4 min) Adrenal Gland (24 min) Adrenergic Effects on Liver Function (2 min) Chemical Synapse Animation (1 min) Cholinergic Neurotransmission (14 min) Return to top of Page   Chapter 5:  Pharmacology of Adrenergic Drugs Introduction Adrenergic Drug Classification Direct-Acting Agents Indirect-Acting Agents Direct vs. Indirect Acting Agents Catecholamine Biosynthesis Review of Catecholamine Synthesis and Release Catecholamine Release and Reuptake Neuroeffector Junction Organic Cation Transporters Adrenergic Agonist-Receptor Interaction and Signaling Pathway Activation Overview of Drug-Receptor Interacting Systems Intracellular Receptor Acting at the DNA level or gene level Tyrosine Kinase-Based Receptors Cytokine Receptors Ligand- and voltage-Gated Ion Channels G-protein and Second Messenger Systems Adrenergic Receptor Subtypes α-Adrenergic Receptors α1-Adrenergic Receptor Subtype α2-Adrenergic Receptor Subtype β-Adrenergic Receptors β1-Adrenergic Receptor Subtype β2-Adrenergic Receptor Subtype β3-Adrenergic Receptor Subtype Return to top of Page Dopamine I α- and β- Adrenergic Receptor Selectivity α1-Adrenergic Receptor Subtype α2-Adrenergic Receptor Subtype β-Adrenergic Receptors (β1- β2 - β3 -Adrenergic Receptor Subtypes) Dopamine Receptors Drugs actings at adrenergic neuroeffector sites (Part I) Drugs acting at adrenergic neuroeffector sites (Part II) Epinephrine Adrenal Medulla 21-hydroxylase deficiency Epinephrine:  Target Organ Effects Cardiac Effects Smooth Muscle Effects Vascular Smooth Muscle Tone Effects on Respiration Asthma β-adrenergic agonists Metabolic Actions Glucagon Free Fatty Acids Miscellaneous epinephrine effects Absorption Metabolism Formulation and chemical stability Some clinical applications Return to top of Page Norepinephrine Cardiovascular effects:  Comparison of norepinephrine vs. epinephrine Effects on blood pressure Vasospastic Angina Dopamine II Dopamine Pathways:  Dopamine and Serotonin Dopamine receptors Second Messenger Systems Dopamine Receptor Distribution Dopamine CNS Pathways Parkinson's Disease I Surgical Interventions Parkinson's Disease II Overview Motor Presentations Non-Motor Presentations Dementia Genetics Differential Diagnosis Pharmacological Basis for Management Pharmacological treatment of Parkinson's disease Levodopa (L-DOPA) Dopamine agonists Ropinerole (Requip), pramipexole (Mirapex) and rotigotine (Neupro) COMT (catechol-O-methyltransferase) Inhibitors MAO-B Inhibitors Anticholinergics Amantadine (Symmetrel) Dopaminergic Systems and Schizophrenia Epidemiology and Biology Genetics Pathophysiology Models in Schizophrenia Serotonin Glutamate Dopamine Review of Dopamine Receptor Subtypes Comparison of Antipsychotic Agents Antipsychotic Drugs and their Side Effects Antipsychotic Drugs and their  structural features Non-Neurological Adverse Effects of Antipsychotic Drugs Dopamine III Cardiovascular Activity Dopamine in Cardiovascular Therapeutics β-Adrenergic Receptor Agonists:  Overview Isoproterenol Dobutamine (Dobutrex) β2-selective adrenergic receptor agonists Short-acting β2-adrenergic agonists Albuterol (Salbutamol) Levalbuterol (Xopenex) Metaproterenol (Alupent) Pirbuterol (Maxair) Terbutaline (Brethine) Fenoterol (Berotec) Long-acting β2-selective adrenergic receptor agonists Salmeterol (Serevent) Formoterol (Foradil) Arformoterol (Brovana) Adverse effects associated with β-adrenergic receptor agonists Return to top of Page α1-Adrenergic Receptor Agonists: Overview Phenylephrine (Neo-Synephrine) Metaraminol (Aramine) Midodrine (Proamatine) α2-Adrenergic Receptor Agonists: Overview Clonidine (Catapres) Adverse effects Apraclonidine (Iopidine) Brimonidine (Alphagan) Guanfacine (Tenex, Intuniv) Guanabenz (Wytensin) Methyldopa (Aldomet) Tizanidine (Zanaflex) Other Sympathomimetic Amines Amphetamine Cardiovascular System Effects Central Nervous System Effects Effects on Fatigue and Sleep Effects on Weight Loss Mechanism of CNS Effects Toxicity Methamphetamine Methylphenidate (Ritalin) Dexmethylphenidate (Focalin) α-Adrenergic Receptor Antagonists:  Overview α-Adrenergic Receptor Antagonist Selectivities Prazosin (Minipress) Doxazosin (Cardura) Terazosin (Hytrin) Alfuzosin (Uroxatral) Silodosin (Rapaflo) Adverse Effects α2-Adrenergic Receptor Antagonists Yohimbine Non-Selective Adrenergic Antagonists Phentolamine "Other" Adrenergic Antagonists Return to top of Page   β-Adrenergic Receptor Antagonists Overview Receptor Sub-Type Pharmacology:  Classification Cardiovascular System Activity Heart Rhythm and Automaticity Antihypertensive Activity Celiprolol (Cardem) Nebivolol (Bystolic) Nipradilol Carvedilol (Coreg) Carteolol (Cartrol) Betaxolol (Kerlone) Pulmonary Effects Metabolic Effects Adverse effects associated with ß-adrenergic receptor antagonist administration Cardiovascular System Pulmonary System Drug overdose and toxicity associated with ß antagonist administration Therapeutic Uses:  ß-adrenergic receptor antagonist Acute Coronary Syndromes Primary Hypertension Clinical Assessment Risk Assessment Secondary Hypertension Renovascular Hypertension Sleep Apnea Primary Aldosteronism Cushing's Syndrome Pheochromocytoma Treatment of Hypertension ß-Adrenergic Blockers Thiazide Diuretics Loop Diuretics Potassium Sparing Diuretics Mineralocorticoid Receptor Antagonists Calcium Channel Antagonists Renin-Angiotensin System Inhibitors α-Adrenergic Receptor Antagonists α2-Adrenergic Receptor Agonists Return to top of Page Heart Failure Functional Capacity Pharmacological Treatment Diuretics ß-Adrenergic Receptor Antagonists Angiotensin Converting Enzyme Inhibitors Angiotensin Receptor Antagonists Aldosterone Antagonism-Spironolactone Digitalis Glycosides Vasodilators Nitrates Miscellaneous Cardiovascular Uses Hypertrophic Obstructive Cardiomyopathy Marfan's syndrome Glaucoma Other Uses Hyperthyroidism Migraine Prophylaxis Stage Fright Recurrent Variceal Bleeding Prophylaxis Specific ß-Adrenergic Receptor Antagonists Propranolol (Inderal) Nadolol (Corgard) Timolol (Blocadren) Pindolol (Visken) Metoprolol (Lopressor) Esmolol (Brevibloc) Acebutalol (Sectral) Labetalol (Normodyne) Carvedilol (Coreg) Betaxolol (Betoptic) Nebivolol (Bystolic) Celiprolol (Cardem) Autonomic Dysfunction Return to top of Page   Pharmacology Practice Questions:  Adrenergic Drug Pharmacology Practice Question Set #1 (General Autonomic Adrenergic Questions) (20 multiple choice questions (mcq)) Practice Question Set #2 (General Autonomic Adrenergic Questions) (10 mcq) Practice Question Set #3 (Adrenergic Drug and Receptor Properties) (10 matching) Practice Question Set #4 (General Autonomic Adrenergic Questions) (10 fill-in-the-blank) Practice Question Set #5 (Epinephrine Pharmacology) (14 mcq) Practice Question Set #6 (Adrenergic Actions at Effector Sites) (10 mcq) Practice Question Set #7 (Pharmacological Actions of Eprinephrine, Dopamine and Norepinephrine) (11 mcq) Practice Question Set #8 (Dopamine Pharmacology) (10 mcq) Practice Question Set #9 (Dopamine, α2 -Receptors and Shock) (10 mcq) Practice Question Set #10 (Clinical Applications and Precautions:  Adrenergic Agents)   (12 mcq) Practice Questions Set #11 (Adrenergic Anatomy, Substance P and Adrenergic Actions) (15 mcq) Practice Questions Set #12 (General Adrenergic Pharmacology and Physiology) (16 mcq) Practice Questions Set #13 (Catecholamines and  Sympathetic Drugs I) (10 mcq) Practice Questions Set #14 (Catecholamines and Sympathetic Drugs II) (10 mcq) Practice Questions Set #15 (Adrenergic System Responsiveness and Indirect-Acting Agents) (10 mcq) Practice Question Set #16 (Epinephrine; Comparative Pharmacology of Epinephrine, Norepinephrine and Isoproterenol) (13 mcq) Practice Question Set #17 (Epinephrine and Vascular Effects) (10 mcq) Practice Questions Set #18 (Epinephrine and Myocardial Effects) (10 mcq) Practice Questions Set #19 (Epinephrine and Smooth Muscle Tone) (10 mcq) Practice Questions Set #20 (Epinephrine and Secretion; Autonomic Tone) (10 mcq) Practice Question Set #21 (Miscellaneous Epinephrine Effects) (10 mcq) Flashcard Set #1 Flashcard Set #2 Case 1 (10 mcq) Case 2 (12 mcq) Case 3 (5 mcq) Case 4 (flashcards) Practice Exam 1 (15 mcq) Practice Exam 2 (30 mcq) Practice Exam 3 (25 mcq) Return to top of Page  Adrenergic Videos Baroreceptor Reflex:  High Blood Pressure (3 min) Nervous System (Pharmacology, Receptors and Physiology (34 min) Catecholamine Biosynthesis (Dopamine, Norepinephrine, Epinphrine) (8 min) Synaptic Release of Neurotransmitter (Noradrenergic) (14 min) Norepinephrine Basic and Clinical Uses (9 min) Epinephrine Basic and Clinical Uses (14 min) Dopamine Pharmacology (27 min) Adrenal Hyperplasia: 21-Hydroxylase Deficiency (18 min) Asthma Symptoms (12 min) Asthma Diagnosis and Treatment (49 min) Insulin and Glucagon (17 min) Parkinson's Disease:  Diagnosis and Treatment (5 min) Parkinson's Disease:  Basal Ganglia Circuitry (4 min) Parkinson's Disease Surgical Intervention (10 min) Parkinsonian Gait (1 min) Parkinsonian Dyskinesia (2 min) Parkinson's Disease:  Physiology and Pharmacology (24 min) Monamine Oxidase (MAO-B):  Use in Parkinson's Disease (9 min) Schizophrenia Research:  Future Directions (75 min) Schizophrenia and Genetics (69 min) Schizophrenia:  Neural Circuits (68 min) Antipsychotic Drug Classification (6 min) Clozapine Pharmacology (2 min) Antipsychotic Drug Pharmacology (10 min) Congestive Heart Failure Animation (4 min) Congestive Heart Failure Lecture (60 min) Asthma Overview (7 min) Albuterol (Asthma) (15 min) Cardiac Arrhythmias Management (Torsades de Pointes Rhythm) (1 min) Cardiac Arrhythmias Management (3rd Degree Atrioventricular Block) (1 min) Myocyte Contractility:  Influence of β1-Receptor Activation (0.5 min) Cardiac Arrhythmias Management (Sinus Tachycardia with Bundle Branch Block) (1 min) Clonidine Pharmacology:  A Review (3 min) Narcolepsy:  Autoimmune Disease (3 min) Amphetamine Pharmacology (15 min) Methamphetamine PSA (60 min) Pharmacological Management of Benign Prostatic Hyperplasia (BPH) (2 min) Adrenergic Receptors:  Agonists and Antagonists (23 min) Beta-Antagonist Use in Managing Arrhythmias (13 min) Nitric Oxide Pharmacology (29 min) Cardiac Automaticity (8 min) Asthma Diagnosis (8 min) Raynauds' Syndrome (5 min) Torsades de Pointes (Cardiac Arrhythmia) (5 min) Renal arterial Stenosis:  Case Study (4 min) Primary and Secondary Hypertention:  A Comparison (7 min) Pheochromocytoma:  Symptoms and Management (9 min) Hypertension and Endocrinology (9 min) Diuretic Drugs:  Sites of Kidney Action (9 min) Renin-Angiotensin-Aldosterone System (12 min) Angiotensin Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (7 min) Congestive Heart Failure (60 min) Heart Failure Animation (4 min) Beta-Blockers and Management of Congestive Heart Failure (10 min) Use of Beta-Blockers in Patients with both Atrial Fibrillation and Congestive Heart Failure (3 min) Sites of Renal Diuretic Activity (9 min) Digioxin (Digitalis Glycosides):  Mechanism of Action in Management of Congestive Heart Failure (5 min) β-Blockers and Management of Hypertrophic Cardiomyopathy (60 min) Propranolol and its use in Marfan Syndrome Complications (12 min) Return to top of Page   Chapter 6:  Pharmacology of Cholinergic Drugs: Spectrum of Action of Cholinergic Esters Cholinergic Effects on Organ Systems Location of Cholinergic Synapses and the Spectrum of Action of Cholinergic Agents Cholinergic Receptors Muscarinic Coupling Nicotinic Muscle Receptor Nicotinic Neuronal Receptor Muscarinic Receptors Type M1 Type M2 Signal transduction mechanisms Choline esters: Comparisons and Contrasts Potentiation by Acetylcholinesterases Pharmacological Effects of Cholinergic Agonists Cardiovascular Effects Vasodilation Negative Chronotropic Decreased SA and AV nodal conduction velocity Negative inotropism (decreased contractility) Effect on ionic currents Gastrointestinal and Urinary Tracts Cellular Events following Cholinergic Receptor Activation Second Messenger Systems Nitric Oxide and Muscarinic Receptor Activation Nitric Oxide Synthase Return to top of Page Some Cholinergic Agents Clinical Uses Agonists Gastrointestinal and Genitourinary Opthalmological Contraindications Adverse Effects: Muscarinic Agonists Indirect-acting Cholinomimetic Drugs  Acetylcholinesterase Inhibitors Overview "Reversible", short-acting "Reversible", intermediate-acting "Irreversible", long-acting Indirect Acting Agents-Table Pharmacokinetics Clinical use in anesthesia Parathion and Malathion Inhibition Mechanisms ACHE Locations Return to top of Page Organ Systems Eye: Ophthalmological Uses Gastrointestinal and Urinary Bladder Myasthenia Gravis Alzheimer's Disease Conditions Resembling Myasthenia Gravis Adverse Effects Cholinergic Antagonists Antimuscarinics Clinical Applications Use in Anesthesia CNS Effects Preoperative medications Sedation Management of reflex bradycardia Third Degree (Complete) Heart Block Combinations with anticholinesterase agents during pharmacological antagonism of nondepolarizing neuromuscular-blocking agents Bronchodilation Management of gastric or intestinal hypersensitivity or secretion Respiratory Tract Effects Ophthalmological Effects Adverse Effects Ganglionic Blocking Agents Antimuscarinic drug effects  on various organ systems Return to top of Page  Pharmacology Practice Questions:  Cholinergic Drug Pharmacology Practice Question Set #1 (Parasympathetic Pharmacology) (13 multiple choice questions (mcq)) Practice Question Set #2 (Localization of Cholinergic Synapses) (13 mcq) Practice Question Set #3 (Physiological Consequences of Autonomic Cholinergic Activity) (15 mcq) Practice Question Set #4 (Classification of Cholinergic Drugs) (12 mcq) Practice Question Set #5 (Clinical Uses of Cholinergic Agents) (12 mcq) Practice Question Set #6 (Cholinergic Agents in Anesthesia) (10 mcq) Flashcard Set #1 Flashcard Set #2 Case 1 (7 mcq) Case 2 (4 mcq) Practice Exam 1 (23 mcq) Practice Exam 2 (21 mcq) Unit Drug List Unit Practice Exams (114 mcq) Return to top of Page  Cholinergic Videos Cholinergic Drugs - Pharmacology Animation (5 min) Muscarinic Cholinergic Receptors (13 min) Muscarinic Receptors:  G Protein Linked 2nd Messenger (22 min) Autonomic Innervation of the Heart (4 min) The Cholinergic Receptor (16 min) Acetylcholinesterase Inhibitors (4 min) Cholinesterase Inhibitors; NMJ Reversal and Anticholinergic Pharmacology (14 min) Return to top of Page       Chapter 7:  Pharmacology of Antihypertensive Drugs  Hypertension:  Introduction Primary hypertension Renin-Angiotensin-Aldosterone System Sympathetic, autonomic nervous system Renal sympathetic nerves Clinical assessment Risk assessment Secondary hypertension Renovascular hypertension Sleep apnea Primary Aldosteronism Cushing's syndrome Pheochromocytoma Hypertension Treatment ß-receptor antagonists Adverse effects Thiazide diuretics Loop diuretics Potassium-sparing diuretics Mineralocorticoid receptor antagonists Calcium channel antagonists Renin-Angiotensin System Inhibitors α-adrenergic receptor antagonists α2-adrenergic receptor agonists Clonidine Guanfacine Guanabenz Methyldopa Return to top of Page  Pharmacology Practice Questions:  Antihypertensive Drug Pharmacology Practice question set 1 (General Questions)   (19 multiple choice questions (mcq)) Practice question set 2 (Causes of Hypertension) (10 mcq) Practice question set 3 (Antihypertensive Drug Classes) (22 mcq) Practice question set 4 (Antihypertensive Drug Action) (15 mcq) Practice question set 5 (Clinical Effects of Antihypertensive Drugs) (12 mcq) Practice question set 6 (General Antihypertensive Pharmacology I) (14 mcq) Practice question set 7 (General Antihypertensive Pharmacology II) (25 mcq) Practice question set 8 (Clinical Consideration and Drugs for Hypertension) (25 mcq) Practice question set 9 (Antihypertensive Drug Classes) (20 mcq) Practice question set 10 (Diuretic Drugs in Hypertension Management) (10 mcq) Practice question set 11 (Physiological Aspects in Hypertension Treatment) (10 mcq) Practice question set 12 (Antihypertensive Drug Classification) (10 mcq) Practice question set 13 (Antiadrenergic Drugs in Hypertension Treatment) (10 mcq) Practice question set 14 (Calcium Channel Blockers in Hypertension Treatment) (10 mcq) Practice question set 15 (Renin and Angiotensin Antagonists in Hypertension) (10 mcq) Flashcard set #1 Flashcard set #2 Flashcard set #3 Flashcard set #4 Practice exam #1 (20 mcq) Practice exam #2 (31 mcq) Practice exam #3 (21 mcq) Return to top of Page  Hypertension Videos Drug Treatment of Hypertension (9 min) Diuretics and Effects on the Kidney (9 min) Return to top of Page   Chapter 8: Pharmacology of Antiarrhythmic Drugs Electrophysiology Cardiac Rhythm Cardiac Electrophysiology Transmembrane potential Sodium Potassium Spontaneous Depolarization Channel Activation Phases of the cardiac action potential and ionic and electrophysiological changes are associated with normal cardiac rhythm Resting membrane potential and conduction velocity Pathophysiology Abnormalities of Cardiac Impulse Initiation Introduction: Arrhythmias and Drug Therapy Antiarrhythmic Drug Video Atrial Fibrillation Drugs that help maintain normal rhythm Mechanisms that predispose to arrhythmias Reentry:  common proarrhythmic conduction abnormality Mechanism of Action of Antiarrhythmic Agents Antiarrhythmic Drug Classes Antiarrhythmic Drugs Part I Antiarrhythmic Drugs Part II Return to top of Page  Pharmacology Practice Questions:  Antiarrhythmic Drug Pharmacology Practice question set #1 (Drug Classes and Side Effects) (21 multiple choice questions (mcq)) Practice question set #2 (General Antiarrhythmic Drug Questions) (20 mcq) Practice question set #3 (Causes of Arrthythmias)  (14 mcq) Practice question set #4 (Class I Antiarrthymic Drugs) (20 mcq) Practice question set #5 (Proarrhythmic Factors) (25 mcq) Practice question set #6 (Mechanisms of Anthiarrhythic Drug Actions)  (10 mcq) Practice question set #7 (Antiarrhythmic action of Adenosine)  (6 mcq) Practice question set #8 (Antiarrhythmic Drug Classification)  (10 mcq) Practice question set #9 (Procainamide) (10 mcq) Practice question set #10 (Qunidine) (10 mcq) Practice question set #11 (Lidocaine) (10 mcq) Practice question set #12 (Disopyramide) (10 mcq) Practice question set #13 (Mexilitine) (10 mcq) Practice question set #14 (Flecanide) (10 mcq) Practice question set #15 (β-Adrenergic Antagonists) (12 mcq) Practice question set #16 (Sotolol Pharmacology) (16 mcq) Practice question set #17 (Amiodarone Pharmacology) (7 mcq) Practice question set #18 (Dronedarone and Dofetilide) (11 mcq) Practice question set #19 (Diltiazem and Verapamil) (8 mcq) Flashcard set #1 Flashcard set #2 Flashcard set #3 Practice exam #1 (20 mcq) Practice exam #2 (23 mcq) Practice exam #3 (28mcq) Return to top of Page  Antiarrhythmic Videos Cardiac Conduction System (11 min) Antiarrhythmic Drugs (88 min) Treating Atrial Fibrillation (87 min) Wolff-Parkinson-White Syndrome (3 min) Return to top of Page   Chapter 9:  Pharmacology of Antianginal Drugs Coronary Arteries Genetics of Coronary Artery Disease Nitric Oxide and Vasodilation Overview Synthesis/Transport Cardiovascular Pulmonary Platelets Nervous system Immune function Pathophysiology Anesthesia Clinical Uses Definition of angina pectoris, including the distinction between classic and variant angina Refractory Angina Prinzmetal's Variant Angina Regulation of Coronary Blood Flow Control of Coronary Blood Flow (Metabolism and Nervous System) Factors influencing Myocardial Oxygen Demand and Supply Treatment objectives: Angina Chronic Management Acute Coronary Syndromes (ACS) Treatment of ACS Pharmacological Interventions:  Overview Nitrates Beta-Receptor Antagonists Calcium Channel Antagonists Return to top of Page Nitrate Pharmacology Overview Mechanisms of Action Nitrate Effects on Coronary Blood Flow Nitrate Effects:  Smooth Muscle Nitrates:  Absorption and Metabolism Toxicities Calcium Channel Antagonists Vascular Effects Mechanism of Smooth Muscle Contraction Effect on Cardiac Cells Absorption, Metabolism, Excretion\ Toxicities Therapeutic Uses Beta-Adrenergic Receptor Antagonists Anti-Anginal Actions Clinical Pharmacology of Antianginal Drugs Nitrates Beta-Adrenergic Antagonists Calcium Channel Blockers Some Specific Anti-anginal Drugs Isosorbide Nitroglycerin Nimodipine (Nimotop) and Felodipine (Plendil) Diltiazem (Cardiazem) Nisoldipine (Sular) Verapamil Return to top of Page  Pharmacology Practice Questions:  Antiangina Drug Pharmacology Practice question set #1 (Antianginal Drugs in Differing Clinical Settings) (8 multiple choice questions (mcq)) Practice question set #2 (Nitric Oxide Pharmacology) (12 mcq) Practice question set #3 (Acute and Chronic Angina Management) (15 mcq) Practice question set #4 (Calcium Channel Antagonists) (20 mcq) Practice question set #5 (Clopidogrel and Related Drugs) (10 mcq) Practice question set #6 (Nitrate Pharmacology) (10 mcq) Practice question set #7 (Calcium Channel Blockers and Ranolazine) (10 mcq) Practice question set #8 (Role of β-Adrenergic Blockers in Angina) (10 mcq) Practice question set #9 (Angina:  Physiology and Pharmacology) (10 mcq) Flashcard set #1 Flashcard set #2 Practice exam #1 (10 mcq) Practice exam #2 (30 mcq) Return to top of Page  Angina Videos Coronary Arteries (4 min) Genetics and Coronary Artery Disease (39 min) Refractory Angina (30 min) Acute Coronary Syndrome (92 min) Treatment of Acute Coronary Syndrome (14 min) James Black:  Testing Propranolol (5 min) Return to top of Page   Chapter 10: Pharmacological Management of Congestive Heart Failure  CHF Overview: Short Video Introduction:  Clinical Presentation (Overview Video Lecture) Epidemiology and Pathophysiology (Video Lecture) CHF Animation Causative Factors with Decreased Ejection Fraction Causative Factors with Preserved Ejection Fraction   Heart failure Classification Routine Assessments Establishing Presence and Probable Heart Failure Cause Additional Tests in Support of Either a Heart Failure Diagnosis or an Alternative Functional Capacity Assessment Plasma B-type Natriuretic Peptide (BNP) Levels Fluid Retention Assessment Elevated Jugular Venous Pressure Chest Radiograph Pedal, Pitting Edema Return to top of Page Drug Treatment Stages of Heart Failure Development and Recommended Therapy Options β-Adrenergic Receptor Antagonists Carvedilol Starling's Law:  Ventricular Performance as Influenced by Ventricular End-Diastolic Volume (Ventricular Stretch) Morbidity and Mortality in Heart Failures, as Influenced by β-Adrenergic Receptor Antagonism Common Cause of Sudden Death in Severe Heart Failure Patients: Arrhythmias The Use of β-Receptor Blockers in Treating Heart Failure Should Be Evidenced-based Diuretics Sites of Action Proximal Tubular Diuretics Loop Diuretics Distal Tubular Diuretics Clinical Uses Toxicity Distal Tubular Diuretics ECG Changes with Hypokalemia Potassium loss and Volume Depletion Gout Angiotensin Converting Enzyme Inhibitors (ACE inhibitors) Aldosterone Antagonism-Spironolactone Digitalis glycosides Vasodilators Nitrates Return to top of Page  Pharmacology Practice Questions:  Drugs for Treating Heart Failure Practice question set #1 (Factors Affecting Myocardial Performance) (17 multiple choice questions (mcq)) Practice question set #2 (Drugs Classes Used in CHF Management) (13 mcq) Practice question set #3 (CHF Causes and Vasomotor Tone) (15 mcq) Practice question set #4 (Autonomic Pharmacology and Vascular Tone) (15 mcq) Practice question set #5 (Symptoms of CHF and Digitalis Inotropism) (19 mcq) Practice question set #6 (Cardiac Decompensation and CHF Symptoms)  (10 mcq) Practice question set #7 (Management of Acute Heart Failure) (7 mcq) Practice question set #8 (Drug Approaches to CHF Management) (10 mcq) Practice question set #9 (Dopamine and Cardiac Glycosides in CHF) (10 mcq) Practice question set #10 (Role of Diuretics in CHF Management) (10 mcq) Practice question set #11 (Diuretics and ACE Inhibitors in CHF) (10 mcq) Practice question set #12 (Diastolic Dysfunction in Heart Failure) (10 mcq) Flashcard set #1 Flashcard set #2 Practice Exam #1 (18 mcq) Practice Exam #2 (42 mcq) Return to top of Page  CHF Videos Congestive Heart Failure Animation 1 (1 min) CHF Lecture (60 min) CHF Pathophysiology (55 min) CHF Animation 2 (4 min) CHF with Reduced Ejection Fraction (48 min) Hypokalemia and CHF (6 min) Diuretics (9 min) Return to top of Page   Chapter 11: Pharmacological Management of Hyperlipidemic States  Definitions Hyperlipidemias--Clinical consequences Athersclerosis Acute pancreatitis Lipoprotein Classification Plasma proteins in atherogenesis Athersclerotic Plaques Components Factors promoting Development Properties High-density lipoproteins (HDL) and atherogenesis Cigarette smoking and CHD Hyperlipoproteinemia Pathophysiology Lipoprotein Metabolism: Normal Catabolism and Synthesis Chylomicrons VLDL LDL Lp(a) Lipoprotein HDL Lipoprotein disorders Overview Primary Hypertriglyceridemia Triglyceride elevation: mechanism Associated conditions Familial hypertriglyceridemia (severe) Familial hypertriglyceridemia (moderate) Familial combined hyperlipoproteinemia Familial lipoprotein lipase deficiency Clinical presentation Familial Apoprotein CII Deficiency Familial dysbetalipoproteinemia Clinical presentation Treatment Return to top of Page Primary Hypercholesterolemia Familial hypercholesterolemia Clinical manifestations (heterzygous) Clinical manifestations (homozygous) Mechanism Clinical management Familial Ligand-Defective Apolipoprotein B Mechanism Clinical consequence Treatment Familial Combined Hyperlipoproteinemia Lp(a) Hyperlipoproteinemia HDL Deficiency Genetic Factors Familial hypoalphalipoproteinemia Secondary Hyperlipoproteinemia Hypertriglyceridemia Hypercholesterolemia Dietary Treatment For patients with elevated serum LDL For patients with elevated triglycerides Return to top of Page Pharmacological Management of Hyperlipidemia Overview Niacin Overview Chemistry/Pharmacokinetics Mechanism of Action Clinical Use Toxicity Gemfibrozil Overview Pharmacokinetics Mechanism of Action Clinical Use Toxicity Bile acid Binding Resins Overview Chemistry/Pharmacokinetics Mechanism of Action Clinical Uses Toxicity HMG-CoA reductase Inhibitors Overview Chemistry/Pharmacokinetics Mechanism of Action Clinical Use Toxicity Drug Combinations Overview Gemfibrozil and Bile Acid-Binding Resin Reductase inhibitor and Binding Acid-Binding Resin Niacin and Bile Acid-Binding Resin Niacin and Reductase Inhibitor Combination of Resin, Niacin, and Reductase Inhibitor Return to top of Page  Pharmacology Practice Questions:  Antilipid Drug Pharmacology Practice question set #1 (Causes and Symptoms of some Dyslipidemias) (8 multiple choice questions (mcq)) Practice question set #2 (Side Effects and Drug Interactions of Anti-Lipid Medications) (5mcq) Practice question set #3 (Risk Factors in Hyperlipidemia) (10 mcq) Practice question set #4 (Elevated Lipid Levels and Heart Disease) (10 mcq) Practice question set #5 (Statins) (10 mcq) Practice question set #6 (Anti-Hyperlipidemic Drug Combinations) (10 mcq) Practice question set #7 (Niacin and its Side-Effects) (10 mcq) Flashcard set #1 Practice exam #1 (7 mcq) Return to top of Page  Hyperlipidemic Videos Hyperlipidemics: Guidelines (1) (7 min) Hyperlipidemics: Guidelines (2) (5 min) Familial Hypercholesterolemia (4 min) Cholesterol and Cardiovascular Disease (89 min) Cardiovascular Pharmacology Unit Drug List Return to top of Page   Chapter 12:  Pharmacology of Sedative Hypnotic Drugs Stages of CNS depression Central/sedhyp/Sedative1.htm#Classification of central nervous system depressants Possible biochemical mechanism of action of anxiolytics, sedatives and hypnotics  Effects on cardiovascular, respiratory and central nervous systems. Comparative Advantages and disadvantages of  sedative-hypnotic classes  Anxiolytics Hypnotics Specific Drug Classes Ethanol Barbituates Benzodiazepines Others Return to top of Page Preoperative Medications: The Role of Sedative Hypnotics and Other Drugs and Issues Benzodiazepines Opioids Antihistamines (including both sedative uses and effects on gastric acid secretion) Antacids Patients who should receive prophylaxis against aspiration Proton Pump Inhibitors Antiemetic Drugs Anticholinergic Agents Centrally-acting α2 agonists Steroids Antibiotics Insulin Preoperative medication differences between adults and children Preoperative medication for ambulatory surgery Benzodiazepines Opioids and Nonsteroidal Analgesics Propofol (Diprivan) in the preoperative setting Anxiety management in the ambulatory surgical setting Aspiration risk in the ambulatory care setting Management of postoperative nausea in the ambulatory care setting Return to top of Page  Pharmacology Practice Questions:  Sedative-Hypnotic Drug Pharmacology Practice question set #1 (General Principles of Sedative-Hypnotic Pharmacology) (18 multiple choice questions (mcq)) Practice question set #2 (Sedative-Hypotics and Anesthesia, e.g. Amnestics) (9 mcq) Practice question set #3 (Benzodiazepines e.g. Diazepam) (20 mcq) Practice question set #4 (Benzodiazepine and Alcohol Pharmacology) (20 mcq) Practice question set #5 (Benzodiazepine Mechanisms of Action) (10 mcq) Practice question set #6 (Benzodiazepine Metabolism) (10 mcq) Practice question set #7 (Benzodiazepines: General Characteristics) (11 mcq) Practice question set #8 (Management of Insomnia: e.g. Zolpidem) (10 mcq) Practice question set #9 (Benzodiazpine-Reversal and Ramelteon Pharmacology) (10 mcq) Practice question set #10 (Barbiturates and Benzodiapines:  Comparative Pharmacology) (10 mcq) Flashcard set #1 Flashcard set #2 Flashcard set #3 Practice exam #1 (15 mcq) Return to top of Page  Sedative-Hypnotic Videos Wernicke's Encephalopathy (6 min) Multiple System Atrophy:  Evaluation (25 min) Return to top of Page   Chapter 13:  Pharmacology of Opioid Analgesics:  Click for Opioid Analgesic Drug Content Opioids:  Click for Advanced Concepts Nomenclature Opioids Definition Source Classification/Chemistry Opioid Classification Chemical Substitution Endogenous Opioid Peptides Pharmacokinetics Absorption Distribution Metabolism Excretion Pharmacodynamics Mechanism of Action Receptor Binding Receptor Types Receptor Types and Physiological Effects Opioid Receptor Subtypes: Table Cellular Actions G-Protein Links Two Well-Defined Actions Spinal Cord Sites of Action Presynaptic Sites Opioid Receptor Distribution Pain and the Brain (video) Primary afferents to pain transmission neurons Systemic Opioid Administration Supraspinal and spinal sites of action Descending pathways Sites of action summary Tolerance and Physical Dependence Opioid Effects: Degree of Tolerance Developed Opioid abuse Return to top of Page Organ Systems CNS Analgesia Spinal Cord Supraspinal Sites of Action Clinical Implications Euphoria Sedation Respiratory Depression Cough Suppression Miosis Clinical Implications Truncal Rigidity Nausea and Vomiting Cardiovascular Effects Gastrointestinal Effects Constipation Biliary Tract Genitourinary Tract Uterus Neuroendocrine Pentazocine  (Talwain)(and other)-- agonist-antagonists Opioid Analgesics: Efficacy; Oral/Parenteral Potency Ratio Summary of Opioid Analgesic Toxic Effects Clinical Use: Opioid Analgesics Analgesia Obstetrical Labor Renal/Biliary Colic Acute Pulmonary Edema Cough Diarrhea Opioids and Anesthesia Anesthetic Premedication Intraoperative Use-general Intraoperative Use-regional Other routes of Administration Toxicity and Side Effects Tolerance Cross-Tolerance Physiologic Dependence Antagonist-Precipitated Withdrawal Psychological Dependence Prescribing Principles and Guidelines Management/Treatment of Overdosage Contraindications/Therapeutic Cautions Pregnancy Impaired Lung Function Impaired Liver/Kidney Function Endocrine Disorders Return to top of Page Specific Drugs Strong Agonists Phenanthrenes Morphine Hydromorphone Oxymorphone (Numorphan) Phenylheptylamines Methadone (Dolophine) Pharmacodynamics Levomethadyl acetate Phenylpiperidines Meperidine (Demerol) Fentanyl Group Fentanyl (Sublimaze) Sufentanil  (Sufenta) Alfentanil (Alfenta) Remifentanil (Ultiva) Morphinans: -- Levorphanol  (Levo-dromoran) Mild/Moderate Agonists Codeine, oxycodone (Roxicodone), dihydrocodeine, hydrocodone Propoxyphene (Darvon) Diphenoxylate (Lomotil) Loperamide (Imodium) Mixed Agonist-Antagonists and Partial Agonists Nalbuphene Buprenorphine (Buprenex) Butorphanol Pentazocine Dezocine Miscellaneous Tramadol Antitussives Opioid Antagonists-Naloxone, Naltrexone, Nalmefene Pharmacodynamics Clinical Use Return to top of Page    Pharmacology Practice Questions:  Opioid Pharmacology Practice question set #1 (General Properties)  (5 multiple choice questions (mcq)) Practice question set #2 (Endogenous Opioid Peptides and Exogenous Agents) (15 mcq) Practice question set #3 (Comparative Opioid Pharmacology: Agonists and Reversal Agents) (10 mcq) Practice question set #4 (Endogenous Opioid Peptides) (10 mcq) Practice question set #5 (Opioid Pharmacology: Desensitization, Clinical Effects, Withdrawal) (10 mcq) Practice question set #6 (Opioids and Clinical Uses) (10 mcq) Practice question set #7 (Opioid Side-Effects and Contraindications) (10 mcq) Practice question set #8 (Opioid Metabolism and Drug Elimination) Practice question set #9 (Comparative Pharmacology: e.g. Meperidine and Morphine) (10 mcq) Practice question set #10 (Fentanyl and Diphenoxylate) (10 mcq) Practice question set #11 (Fentanyl and Opioid Overdose) (10 mcq) Practice question set #12 (Methadone and Propoxyphene) (10 mcq) Practice question set #13 (Pentazocine and Buorphanol) (10 mcq) Practice question set #14 (Opioid Distribution and Metabolism) (10 mcq) Practice question set #15 (Antitussive Effects of Opioids) (10 mcq) Practice question set #16 (Opioids and Pain Management) (10 mcq) Practice question set #17 (Opioids: General Questions) (10 mcq) Flashcard set #1 Practice exam #1 (10 mcq) Return to top of Page  Opioid Video Pain and the Brain (88 min) Return to top of Page   Chapter 14: Pharmacology of General Anesthetics Factors influencing Rate of Induction Anesthetic Potency Differences between Inhalational Agents Second-Gas Effects Diffusional Hypoxia Fixed (intravenous) anesthetics Rationale for preanesthetic medications Sedative-Hypnotics including anxiolytics Opioids Antiemetics Antipsychotics Antihistamine Anticholinergics Gastrokinetic Drugs Inhaled anesthetics Halothane (Fluothane)  Nitrous oxide Desflurane (Suprane) Isoflurane (Forane) Enflurane (Ethrane) Sevoflurane (Sevorane, Ultane) Return to top of Page Comparative Pharmacology and Physiology of Anesthetics Inhalational agents and the CNS Seizure Activity Cerebral Blood Flow (CBF) Cerebral Metabolic Requirements (CMR) Intracranial Pressure Clinical Correlations Neurosurgical Considerations Management of intracranial volume Mannitol (Osmitrol) Furosemide (Lasix) Corticosteroids Hyperventilation Therapeutic goals ICP and skeletal muscle relaxants Succinylcholine (Anectine) Nondepolarizing agents Steroidal agents Induction sequence in patients with elevated ICP Anesthesia maintenance: supratentorial tumor cases Return to top of Page Inhalational agents and the Cardiovascular System Dose-dependent and drug-specific effects Mean Arterial Pressure (MAP) Heart Rate Cardiac Output/Stroke Volume Systemic Vascular Resistance Duration of Anesthetic Administration and Cardiac Effects Pulmonary Vascular Resistance Cardiac Arrhythmias Coronary Blood Flow Neurocirculatory Responses -- Desflurane (Suprane) Preexisting myocardial disease and inhaled anesthetic effects Ventilation Effects Breathing Patterns Ventilatory responses to CO2 Surgical stimulation Mechanism of Anesthetic-induced ventilation depression Hypoxemia: Ventilatory response Airway Resistance (volatile anesthetics) Hepatic Effects Volatile Anesthetics and Drug Clearance Hepatotoxicity Overview Hepatotoxicity: Halothane (Fluothane) Halothane (Fluothane) Hepatitis Enflurane (Ethrane), Isoflurane (Forane), and Desflurane (Suprane) Skeletal Muscle Effects and Volatile Anesthetics Neuromuscular Junction Malignant Hyperthermia and volatile anesthetics Obstetrical Effects and Volatile Anesthetics Volatile anesthetics-obstetrical effects Nitrous Oxide-obstetrical effects Renal Effects-Volatile Anesthetics: Overview Fluoride-induced renal toxicity Vinyl Halide Nephrotoxicity Return to top of Page Anesthesia Fundamentals:  Physics and chemistry for anesthesia:  Click for Content  Pharmacology Practice Questions:  Anesthesia Fundamentals Practice question set #1 (Fundamental Concepts) (5 multiple choice questions (mcq)) Practice question set #2 (Partial Pressure) (11 mcq) Practice question set #3 (Anesthetics; Physiological Effects) (20 mcq) Practice question set #4 (Comparative Pharmacology of Anesthetics) (20 mcq) Practice question set #5 (Anesthetic Agents; Adverse Effects) (20 mcq) Practice question set #6 (Antiemetic Drugs) (12 mcq) Practice question set #7 (Properties of Various Anesthetics) (15 mcq) Practice question set #8 (Intracranial Pressure I) (20 mcq) Practice question set #9 (Intracranial Pressure II) (26 mcq) Practice question set #10 (Vasculature Effects of Anesthetics) (13 mcq) Case 1 (3 mcq) Case 2 (2 mcq) Case 3 (2 mcq) Case 4 (3 mcq) Case 5 (3 mcq) Case 6 (2 mcq) Case 7 (3 mcq) Case 8 (2 mcq) Return to top of Page   Chapter 15:  Pharmacology of Local Anesthetics Overview: Chemical Properties Pharmacokinetics Absorption and Distribution Pulmonary Extraction Placental Transfer Clearance Vasoconstrictors with local anesthetics Local Anesthetic Combinations Side-Effects/Toxicities Clinical Uses Return to top of Page  Pharmacology Practice Questions:  Local Anesthesia Practice question set #1 (General Principles and Pharmacokinetics) (20 multiple choice questions (mcq)) Practice question set #2 (Absorption and Distribution of Local Anesthetics) (20 mcq) Practice question set #3 (Local Anesthetic Toxicities and Contraindications) (20 mcq) Practice question set #4 (Local Anesthetics and Clinical Considerations) (35 mcq) Practice question set #5 (Amide and Ester-Type Agents; Metabolism) (10 mcq) Practice question set #6 (Properties of Local Anesthetics) (10 mcq) Practice question set #7 (Comparative Pharmacology of Local Anesthetics) (10 mcq) Practice question set #8 (Differential Uses and Toxicities of Local Anesthetics) (10 mcq) Practice question set #9 (Clinical Issues in Local Anesthetic Uses) (10 mcq) Case 1 (4 mcq) Case 2 (4 mcq) Case 3 (3mcq) Practice exam #1 (23 mcq) Practice exam #2 (39 mcq) Return to top of Page  Local Anesthetic Videos Cauda Equina Syndrome (12 min) Basic Pharmacology (35 min) Regional Anesthesia and Analgesia (16 min) Return to top of Page   Chapter 16:  Pharmacology of Antipsychotic Drugs Schizophrenia Clinical Manifestations Characteristic perturbations Syndrome Overview Positive Symptoms Negative Symptoms Four Main Syndrome Subtypes Catatonic type Paranoid type Disorganized type Residual type Prognosis Epidemiology Three Principle Risk Factors Genetic Early developmental change Winter birth Proposed Pathophysiology Structural/Function anomalies Dopamine Hypothesis Return to top of Page Antipsychotic Drug Classification Phenothiazine Compounds Subclasses Thioxanthene Butyrophenones Miscellaneous Chemical Structures Pharmacokinetics Absorption Metabolism Excretion Pharmacology Overview Psychological Effects Endocrine Changes Cardiovascular Effects Adverse Effects/Reactions Neurological - Extrapyramidal Parkinson's Syndrome Akisthisia Acute Dystonia Tardive Dyskinesia Management Drug Classes: Potency and Toxicities Autonomic Effects Metabolic/Endocrine Cardiotoxicity Ocular Effects Malignant Neuroleptic Syndrome Drug Interventions Allergic/Toxic Reactions Drug-Drug Interactions Clinical Indications for Antipsychotic Drugs Schizophrenia Schizoaffective Disorder Manic Component in Bipolar Affective Disorder Other "psychiatric" Indications Non-Psychiatric Indications Return to top of Page Lithium Overview Anti-manic/Mood Stabilizing Other Mood Stabilizers Bipolar Affective Disorder Symptomatology Lithium Pharmacology Pharmacokinetics Pharmacodynamics Ion Transport Effects Neurotransmitter Effects Second Messenger Effects Lithium Clinical Pharmacology Bipolar Disorder: Manic Phase Depressive Phase: other drugs may be required Adverse Effects Other Applications Drug-Drug Interactions Adverse Effects Valproic Acid Carbamazepine Return to top of Page  Pharmacology Practice Questions:  Drugs for Managing Psychosis Practice question set #1 (Side Effects of Antipsychotic Drugs) (10 multiple choice questions (mcq)) Practice question set #2 (General Classification and Properties I) (16 mcq) Practice question set #3 (Lithium I) (4 mcq) Practice question set #4 (CNS Drug Effects and Receptors) (10 mcq) Practice question set #5 (Phenothiazine and Buterophenones) (10 mcq) Practice question set #6 (General Classifications and Properties II) (10 mcq) Practice question set #7 (Atypical Antipsychotic Drugs and Side Effects) (10 mcq) Practice question set #8 (Clozapine) (10 mcq) Practice question set #9 (Newer Antipsychotic Drugs, e.g. Olazapine, Ziprasidone) (10 mcq) Practice question set #10 (General Classifications and Properties III) (10 mcq) Practice question set #11 (Management of Bipolar Disorder) (10 mcq) Practice question set #12 (Lithium II) (10 mcq) Practice question set #13 (Lithium III) (10 mcq) Return to top of Page   Chapter 17:  Pharmacology of Antidepressant Drugs Depression as a Mood Disorder Depression in Association with Medical Illnesses Cardiac Disease Cancer Neurologic Disorders Diabetes Mellitus Hypothyroidism HIV Diagnostic Criteria Based on DSM-IV Additional Clinical Issues Suicide Dysthymic Disorder Predisposition Unipolar Depression Differential Diagnosis in Depression I Chronic Pain and Depression Depression and Alcoholism Childhood and Adolescent Depression Depression in the Geriatric Setting Etiology of Depression Genetics I Type 1 receptor for corticotrophin-releasing factor (CRHR1) Glucocorticoid receptor gene (GR) Gene coding for chaperone protein, FKBP5 Serotonin transporter gene (SLA6A4) Catechol-O-methyl transferase (COMT) gene Brain-derived neurotrophic factor gene (BDNF) Major depressive disorder:  risk factors for development Genetic risk factors Serotonin transporter Tryptophan hydroxylase 2 isoform BDNF Anatomical Correlations in Depression Pathophysiology Theories of Depression Biological Neuroendocrine Pyschoanalytic Theories of Depression Behavioral Models Cognitive behavior therapy (CBT) CBT in management of depression Differential Diagnosis in Depression II Major endogenous depression and bipolar disorder Depression and anxiety Depression and somatoform disorder Depression and substance abuse Depression and dementia Return to top of Page Antidepressant Medication Overview I Serotonin and norepinephrine reuptake inhibitor mechanisms Distribution of some brain serotonin receptor subtypes Evidence suggesting involvement of serotonin and NE in depression Mechanisms for long-term clinical efficacy Hippocampus Neurotransmitter transporters Norepinephrine transporter Brain distribution Autoradiography Serotonin transporter Clinical issues in antidepressant therapy I Classification of antidepressant medications Norepinephrine reuptake inhibitors 3D structures and pharmacophores Serotonin selective reuptake inhibitors 3D structures and pharmacophores Atypical antidepressants 3D structures and pharmacophores Monoamine oxidase inhibitors (MAOI) 3D structures and pharmacophores Antidepressant medication side effects Antimuscarinic effects Effects due to blockade of α-type adrenergic receptors Antihistamine actions Side effects associated with norepinephrine uptake inhibitors Side effects associated with SSRIs Side effects associated with dopamine reuptake inhibitors Side effects associated with dopamine receptor blockers Side effects associated with serotonin receptor blockers Cardiovascular system side effects Antidepressant Medications II Monoamine Oxidase Norrie Disease Monoamine oxidase localization Monoamine Oxidase Inhibitors (MAOIs) Monoamine oxidase inhibior (MAOI) metabolic products Non-selective monoamine oxidase inhibitor antidepressants Selective monoamine oxidase inhibitor antidepressants Serotonin syndrome Return to top of Page Antidepressant Medications II Selective Serotonin Reuptake Inhibitors (SSRIs) Introduction STAR*D study Mechanism(s) of action Short-term SRRI effects Long-term SSRI effects Neurogenesis SERT  (Serotonin transporter) effects Genetics Pharmacokinetics Drug-drug interactions Fluoxetine (e.g. Prozac) Chirality Structure-activity relationships Mechanism(s) of Action Pharmacokinetics Geriatric patients Paroxetine (e.g. Paxil) Comparative structure with fluoxetine Bioavailability and pharmacokinetics Drug-drug interactions Suicidality issues Geriatric patients Citalopram (Celexa) Pharmacokinetics QT syndrome Clinical efficacy Escitalopram (Lexapro) Contraindications Clinical Issues Sertraline (Zoloft) Introduction Antidepressant medication and placebo controversies Sertraline pharmacokinetics Clinical trials and drug effectiveness Fluvoxamine (Luvox) Introduction Lecture on Obsessive Compulsive Disorder (OCD) Pharmacokinetics Hepatic and renal dysfunction Clinical efficacy Some contraindications Serotonin-Norepinephrine Reuptake Inhibitors:   Duloxetine and Venlafaxine Introduction Duloxetine (Cymbalta) Clinical indications Management of neuropathic pain lecture Emerging therapies for neuropathic pain lecture Fibromyalgia lecture Contraindications Warning and Precautions Venlafaxine (Effexor) Overview Clinical Trials Contraindications, warnings and precautions Venlafaxine (and other agents in bipolar disorder) Bipolar disorder lecture Return to top of Page Tricyclic Antidepressants Introduction Side effect profile Drug elimination and metabolism Amitriptyline (Elavil) Imipramine (Tofranil) Formulations Metabolism Clinical Uses Doxepine (Sinequan) Introduction Metabolism Clinical Uses Clomipramine (Anafanil) General information Short video discussion of OCD Trimipramine (Surmontil) Trimipramine metabolism and CYP2D6 polymorphism Monoamine Oxidase Inhibitors I Monamine Oxidase Inhibitors II Monamide Oxidase Inhibitors III Return to top of Page  Pharmacology Practice Questions:  Drugs for Managing Depressive Illness Practice question set #1 (Classification of Depressive Disorders and Medications) (10 multiple choice questions (mcq)) Practice question set #2 (Clinical Considerations in Depressive Disorders I) (15 mcq) Practice question set #3 (General Aspects of Depression and its Management) (17 mcq) Practice question set #4 (Clinical Considerations in Depressive Disorders II) (17 mcq) Practice question set #5 (Atypical Antidepressants and MAO Inhibitors) (15 mcq) Practice question set #6 (Clinical Consideration in Depressive Disorders III) Practice question set #7 (Bipolar Disorder and Approaches in Treating Depression) (15 mcq) Practice question set #8 (Classifications and Properties of Antidepressant Drugs) (10 mcq) Practice question set #9 (Side-Effects of Antidepressants e.g. Serotonin Syndrome) (10 mcq) Practice question set #10 (Pharmacology of Antidepressants and Classifications) (10 mcq) Practice question set #11 (Antidepressant Agents and the Serotonin System) (10 mcq) Practice exam #1 (17 mcq) Return to top of Page  Antidepressant Drug Videos Depressive Illness (58 min) Depression Associated with Cancer (7 min) Dementia, Delirium and Depression (2021 Symposium) (36 min) Clinical Differences:  Delirium, Dementia, and Depression (36 min) Depressive Disorder and Genetics (3 min) Cognitive Behavioral Therapy for Depression (5 min) Cognitive Behavioral Therapy I (8 min) Cognitive Behavioral Therapy II (6 min) Bipolar Disorder (30 min) Serotonin Selective Reuptake Inhibitors (7 min) Arrhythmias Associated with Tricyclic Antidepressants I (4 min) Arrhythmias Associated with Tricyclic Antidepressants II (1 min) Akathisia and Dystonia (Dopamine Receptor Anatagonism Side Effect) (12 min) Serotonin Syndrome (35 min) Placebo and Antidepressant Drug Effects (37 min) Fluvoxamine in OCD and Anxiety (60 min) Neuropathic Pain Management (32 min) Newer Approaches for Neuropathic Pain (47 min) Fibromyalgia Management (87 min) Bipolar Disorder (59 min) Obsessive Compulsive Disorder (28 min) Return to top of Page   Chapter 18:  Pharmacology of AntiParkinson's Disease Drugs Parkinson's Disease Characteristics Neuroanatomical Correlates of Disease Neuronal Loss in Parkinson's Disease Introduction to Dopamine Dopamine Structure Dopamine Formation Dopamine and the Basal Ganglia Brain Dopamine and Serotonin Pathways Dopamine Receptors Proposed Structure G-protein Generalized Structural Model The G protein Cycle Second Messengers after Dopamine Receptor Activation Dopamine Receptor Distribution Dopamine CNS Pathways Dopamine and Parkinson's Disease Substantia Nigra Anatomy Basal Ganglia Anatomical Circuitry Neuroanatomy Tutorial (Video) Basal Ganglia Circuitry Diagram Basal Ganglia Connectivity Diagram Surgical Intervention for Management of Parkinson's Disease Deep Brain Stimulation of Subthalamic Nuclei Parkinson's Disease:  Shaking Palsy Disease Overview The Four Principal Motor Features of Parkinson's Disease Parkinson's Disease Sketch (Postural Changes) Parkinsonian Gait Demonstration Video Return to top of Page Non-motor presentations in Parkinson's Disease Autonomic Dysfunction Neuropsychiatric Presentations Depression Anxiety Cognitive Dysfunction Dementia Dementia and Parkinson's Disease:  Video α-Synuclein and Amyloid-Related in Parkinson's Dementia Events in α-synculein toxicity Psychosis Genetics and Parkinson's Disease Differential Diagnosis in Parkinson's Disease Wilson's Disease Huntington's Disease Multi-System Atrophy (Shy-Drager Syndrome) Progressive Supranuclear Palsy Creutzfeldt-Jakob Disease Corticobasal Degeneration Cellular Pathologic Manifestation Dopamine-Related Drugs in Treatment of Parkinson's Disease L-DOPA  Parmacological Treatment of Parkinson's Disease:  Overview Dyskinesia Development Parkinson's Disease Video:  Dyskinesia Other Adverse Effects Dopamine Agonists Ropinerole (Requip) Pramipexole (Mirapex) Side effects:  dopamine agonists Return to top of Page Catechol-O-Methyl Transferase Inhibitors (COMT inhibitors) MAO-B Inhibitors AntiCholinergic Agents Amantadine (Symmetrel) Return to top of Page  Pharmacology Practice Questions:  Drugs for Treating Parkinson's Disease Practice question set #1 (Neurological Presentations:  Parkinson's Disease) (10 multiple choice questions (mcq)) Practice question set #2 (Drugs Used in Parkinson's Disease) (10 mcq) Practice question set #3 (Trade Names of AntiParkinson's Disease Drugs) (flashcards) Practice question set #4 (Dopamine Pharmacology) (10 mcq) Practice question set #5 (L-DOPA) (10 mcq) Practice question set #6 (L-DOPA; COMT Inhibitors; Dopamine Antagonists) (10 mcq) Practice question set #7 (Cholinergic Drugs in Parkinson's Disease Management) (7 mcq) Practice question set #8 (General Questions  (12 mcq) Practice exam #1 (11 mcq) Return to top of Page  Parkinson's Disease Videos Parkinson's Disease Treatment (5 min) Basal Ganglia Circuitry (4 min) Deep Brain Stimulation (DBS) (10 min) Parkinsonian Gait (1 min) Alzheimer's Disease and Parkinson's Disease (89 min) Exercise and Cognition (58 min) Parkinson's Dyskinesia (3 min) Return to top of Page   Chapter 19:  Pharmacology of AntiSeizure Agents Partial seizures Antiepileptic drugs side effect profiles Drug-Drug Interactions Drugs Used to Treat Grand Mal, Status Epilepticus, and Partial Seizures Absence Seizures Some Important Anti-Epileptic Drugs Return to top of Page  Pharmacology Practice Questions:  Drugs for Managing Seizure Disorders Practice question set #1 (Seizure Types and Drug Management) (10 multiple choice questions (mcq)) Practice question set #2 (Phenytoin I and Valproate) (10 mcq) Practice question set #3 (Phenytoin II) (10 mcq) Practice question set #4 (Carbamazepine; Ethotoin) (10 mcq) Practice question set #5 (Barbiturates; Oxcarbazepine) (10 mcq) Practice question set #6 (Primidone, Gabapentin; Felbamate) (10 mcq) Practice question set #7 (Lacosamide; Pregabalin; Gabapentin) (10 mcq) Practice question set #8 (Peramenel; Rufinamide) (10 mcq) Practice question set #9 (Ethosuxamide; Tiagabine) (10 mcq) Practice question set #10 (Lamotrigine; Lacosamide; Levetiracetam) (10 mcq) Practice question set #11 (Benzodiazepines e.g. Diazepam; Lorazepam) (10 mcq) Practice question set #12 (Absence and Partial Seizure Management) (7 mcq) Practice exam #1 (18 mcq) Return to top of Page   Chapter 20: Pharmacology of Neuromuscular Blocking Drugs Skeletal muscle relaxants Spasticity Table: Anti-spasmolytic drugs Diazepam (Valium) Baclofen (Lioresal) Tizanidine (Zanaflex) Dantrolene (Dantrium) Calcium Channel Structure Drugs for Acute Local Spasm Neuromuscular-blocking agents Chemistry-Structure Pharmacokinetics: Neuromuscular-blocking drugs Introductory comments about specific Nondepolarizing agents Vecuronium (Norcuron) vs Pancuronium (Pavulon) Rocuronium (Zemuron) Atracurium (Tracrium) Cisatracurium (Nimbex) Mivacurium (Mivacron) Depolarizing neuromuscular-blocking drugs Pharmacodynamics Clinical Uses Depolarization Neuromuscular-blockade:  Succnylcholine Succinylcholine (Anectine)-- adverse effects Nondepolarizing blocking drugs Clinical Pharmacology:  Role of neuromuscular blockade in anesthesia Some neuromuscular-blocking drugs Return to top of Page  Pharmacology Practice Questions:  Drugs that Block Neuromuscular Transmission Practice question set #1 (Classification and General Pharmacology of NMJ Blockers) (10 multiple choice questions (mcq)) Practice question set #2 (Depolarizing and Non-Depolarizing NMJ Antagonists) (10 mcq) Practice question set #3 (Dantrolene; Baclofen) (12 mcq) Practice question set #4 (Pharmacokinetics) (20 mcq) Practice question set #5 (Succinylcholine) (20 mcq) Practice question set #6 (Non-Depolarizing NMJ Antagonists e.g. Pancuronium) (20 mcq) Case 1 (2 mcq) Case 2 (3 mcq) Case 3 (2 mcq) Return to top of Page  NMJ Antagonist Videos Spasticity and Spasms (10 min) Malignant Hyperthermia (58 min) NMJ Blockers (58 min) Return to top of Page     Chapter 21:  Pharmacology of Histamine Introduction Chemistry/Pharmacokinetics Tissue Distribution Formation Inactivation Storage/Release Immunological Degranulation Release Regulation Response Modulation by Histamine Pharmacodynamics-Mechanism of Action Receptors Organ Systems Cardiovascular Gastrointestinal Bronchiolar Nerve Endings Secretory Tissue Clinical Pharmacology-Uses Toxicity Histamine Antagonist Introduction Histamine Antagonist Pharmacodynamics H1 Receptor Blockade H1 Receptor Antagonists General Properties Receptor Types:  Sites of Action Non-Histamine Receptor-Mediated Effects Sedation Antiemetic/Antinausea AntiParkinsonism Anticholinergic Anti-α-adrenergic Anti-Serotonergic Local Anesthetic Clinical Uses: H1 Histamine Receptor Blockers Allergic Reactions H1 histamine receptor blockers Second-generation H1 histamine receptor blockers Motion Sickness Nausea and Vomiting (Pregnancy) H1 Blockers: Toxicity Allergic Rhinitis H1 Antihistamines - Uses Newer H1 Antihistamines Topical α-adrenergic Agonists Oral α-adrenergic Agonists Cromolyn sodium Intranasal glucocorticoids Immunotherapy Drug-Drug Interactions Second-generation H1 blockers H2 Receptor Antagonists Introduction/Overview Drug Listing Pharmacodynamics Mechanism of Action Effects on organ systems Gastric Acid Secretion and Stomach motility Effects unrelated to H2 receptor blockade Clinical Uses: H2 Receptor Antagonists Peptic Ulcer Duodenal Disease Gastric Ulcer Gastroesophageal Reflux Disease Hypersecretory States Toxicity: H2 Receptor Antagonists Drug-Drug Interactions Return to top of Page  Pharmacology Practice Questions:  Histamine and Bradykinins Practice question set #1 (General Histamine Pharmacology; H2 Antagonists) (8 multiple choice questions (mcq)) Practice question set #2 (Histamine Pharmacology I (9 mcq) Practice question set #3 (Histamine Pharmacology II) (10 mcq) Practice question set #4 (Histamine H1 Receptor Antagonists) (10 mcq) Practice question set #5 (Histamine H1 vs. H2 Antagonists) (10 mcq) Practice question set #6 (Histamine Antagonist Metabolism and Side Effects) (10 mcq) Practice question set #7 (Clinical Applications of Histamine Antagonists and Side Effects) (10 mcq) Practice question set #8 (Histamine H2 Antagonists) (10 mcq) Practice question set #9 (Histamine Antagonists: Clinical Applications) (10 mcq) Practice question set #10 (Kinins I) (10 mcq) Practice question set #11 (Kinins II) (10 mcq) Flashcards set #1 Return to top of Page   Chapter 22: Serotonin Pharmacology Chemistry Storage Major site-ECC CNS locations CNS effects Degradation Pharmacodynamics-Mechanisms of Action Serotonin Receptor Subtypes Tissue and Organ Systems Cardiovascular Actions Gastrointestinal Effects Nervous System Clinical Pharmacology Medications Used to Treat Migraine (Short Video) Serotonin Agonists Buspirone (BuSpar) Sumatriptan (Imitrex) Migrane Mechanism Video Adverse Effects Contraindications Serotonin Antagonists Cyproheptadine (Periactin) Clinical Use Ketansarin Ritanserin Ondansetron (Zofran) Anti-emetics (short Podcast) Clinical Uses Granisetron (Kytril) Tropisetron Dolasetron Return to top of Page  Pharmacology Practice Questions:  Serotonin Pharmacology Practice question set #1 (Serotonin Synthesis; Localization; GI Effects) (10 multiple choice questions (mcq)) Practice question set #2 (General Serotonin Pharmacology I (10 mcq) Practice question set #3 (General Serotonin Pharmacology II (10 mcq) Practice question set #4 (Serotonin System in Emesis; Serotonin Agents as Antiemetics) (10 mcq) Practice question set #5 (Autacoid Pharmacology) (10 mcq) Practice question set #6 (Serotonin and the Central Nervous System) (10 mcq) Practice question set #7 (Serotonin and Sleep; Cardiovascular Aspects) (10 mcq) Practice question set #8 (Serotonin Agents and Organ System Effects) (10 mcq) Practice question set #9 (Serotonin and Carcinoid; Serotonin Syndrome) (10 mcq) Practice question set #10 (Serotonin and Migrane) (10 mcq) Practice question set #11 (Triptans and other agents in Migrane Management) (10 mcq) Practice exam #1 (17 mcq) Practice exam #2 (37mcq) Flashcards set #1  Serotonin Videos Migrane Medications (2 min) Migrane Mechanisms(14 min) Anti-Emetics (8 min) Return to top of Page   Chapter 23: Ergot Alkaloid Pharmacology Overview Ergot Poisoning-Symptoms Chemistry and Pharmacokinetics Pharmacodynamics Mechanism of Action Receptor Types Effects on Organ Systems CNS Hallucinogenic Dopamine-receptor interactions Extrapyramidal Prolactin release regulation Vascular Smooth Muscle Anti-migraine Actions Drugs to treat migrane Overdosage-Toxicity Uterine Smooth Muscle Other Smooth Muscles Gastrointestinal Ergot Alkaloids: Clinical Pharmacology Migraine Short Introductory Video Clinical Presentations Familial Migraine Pathophysiology Clinical Presentation Video Serotonin Drug Treatment Migraine Prophylaxis Hyperprolactinemia Postpartum Hemorrhage Ergot Toxicity Most common Vasospasm Chronic Toxicities Contraindications Return to top of Page  Pharmacology Practice Questions:  Ergot Pharmacology Practice question set #1 (Ergot Receptors) (9 multiple choice questions (mcq)) Practice question set #2 (Ergot Pharmacology (8 mcq) Practice question set #3 (Ergot Pharmacology; Bromocriptine) (10 mcq) Practice question set #4 (Ergotamine; Dihydroergotamine Pharmacology) (10 mcq)  Ergot Drug Videos Managing migrane headache (5 min) Migrane Headaches (82 min) Return to top of Page   Chapter 24:  Vasoactive Peptide Pharmacology Angiotensin Overview: Biosynthesis Renin and regulation of renin secretion Renin-Angiotensin System Activity Renin-Angiotensin short video Renin Secretion Rate Macula densa Renal Vascular Receptors Angiotensin II Sympathetic nervous system Drug Effects Stimulation Inhibition Angiotensinogen Angiotensin I Converting Enzyme Angiotensinase Angiotensin II - Actions Sites of Action Renin-Angiotensin Systems Physiology Direct Renal Effects:  Table Cardiovascular Effects Vasopressor response Autonomic responses Inotropism Adrenal Cortical Effects Renal Effects CNS Effects Cell-growth/mitogenic actions Angiotensin Receptors Overview Major Receptor Subtypes -AT1 & AT2 Vascular Smooth Muscle - Coupling Mechanisms Renin-Angiotensin_Inhibitors Blockade of Renin Secretion Renin Inhibitors Converting Enzyme Inhibitors (ACE inhibitors) ACE inhibitors: Clinical Use Angiotensin Antagonists Amino acid substitutions Saralasin Receptor Blockers Losartan,Valsartan Clinical Uses Kinins Overview Kallikreins Localization Kallikrein Precursors Kininogens Tissue and Plasma Kinin Formation Bradykinins Lysylbradykinins Methionyllysylbradykinins Physiological Effects Cardiovascular Vasodilatation Mechanism of Action Vasoconstriction Mechanism of Action Blood Pressure Effects Endocrine and Exocrine Effects Inflammation Sensory Nerves Return to top of Page  Pharmacology Practice Questions:  Vasoactive Peptide Pharmacology Practice question set #1 (Renin-Angiotensin) (10 multiple choice questions (mcq)) Practice question set #2 (Renin-Angiotensin) (10 mcq) Practice question set #3 (Renin-Angiotensin) (10 mcq) Practice question set #4 (Kinins) (10 mcq) Case #1 (2 mcq) Case #2 (3 mcq) Return to top of Page  Vasoactive Peptide Video Renin-Angiotensin-Aldosterone System (4 min) Return to top of page   Chapter 25:  Pulmonary Pharmacology Introduction Definition Frequency of Occurrence Asthma Types Triggering Factors Pathogenic Mechanisms Systems Pathophysiology Pathophysiologic manifestations Characteristics of compromised pulmonary function Clinical Features Differential Diagnosis Rationale for Pharmacological Intervention Drugs Used in Asthma Management Cromolyn (Intal) and Nedocromil (Tilade) Methylxanthines Sympathomimetic Drugs Muscarinic Antagonists Corticosteroids Leukotriene Pathway Inhibitors Return to top of Page  Pharmacology Practice Questions:  Asthma, COPD, Pulmonary Hypertension Practice question set #1 (Introduction to Asthma Pharmacology) (10 multiple choice questions (mcq)) Practice question set #2 (Drugs Used in Asthma (10 mcq)  Practice question set #3 (Pathophysiology of Asthma) (10 mcq) Practice question set #4 (Basic and Clinical Aspects of Asthma) (10 mcq) Practice question set #5 (Chronic Obstructive Pulmonary Disease (COPD)) (10 mcq) Practice question set #6 (Bronchodilator Drugs; β-Adrenergic Receptor Agonists) (10 mcq) Practice question set #7 (β-Adrenergic Receptor Agonists (Long and Short Acting); Inhaled Corticosteroids) (10 mcq) Practice question set #8 (β-Adrenergic Receptor Agonists; Methylxanthines e.g. Theophylline) (10 mcq) Practice question set #9 (Methylxanthines; Antimuscarinic Agents) (10 mcq) Practice question set #10 (Inhaled Corticosteroids I; Antimuscarinic Drugs) (10 mcq) Practice question set #11 (Inhaled Corticosteroids II) (10 mcq) Practice question set #12 (Inhaled Corticosteroids III:  Side/Adverse Effects) (10 mcq) Practice question set #13 (Cromolyn; Phosphodiesterase Inhibitors; Leukotriene Pathway Inhibitors I) (10 mcq) Practice question set #14 (Leukotriene Pathway Inhibitors II) (10 mcq) Practice question set #15:  (Targeted Monoclonal Antibody Therapy, e.g. Omalizumab, Mepolizumab,  Benralizumab) (13 mcq) Practice question set #16 (Treatment of Pulmonary Hypertension I:  Prostenoids) (10 mcq) Practice question set #17 (Treatment of Pulmonary Hypertension II:  Endothelin (10 mcq) Receptor Blockers; Phosphodiesterase Type-5 Inhibitors) Flashcards set #1 Return to top of Page  Pulmonary Pharmacology Videos Asthma Guidelines 2020 (49 min) Asthma:  Diagnosis and Treatment (7 min) Types of Asthma Medications (4 min)   Chapter 26:  Renal Pharmacology Renal Physiology Review Diuretic Drug Classes Carbonic Anhydrase Inhibitors Clinical Applications Toxicity Loop Diuretics Mechanism of Action Properties Clinical Uses Toxicity Thiazide Diuretics Properties Mechanism of Action Clinical Uses Toxicity Potassium-Sparing Diuretics Mechanism of Action Clinical Uses Toxicity Osmotic Diuretics Properties Clinical Uses Toxicity Diuretic Therapy in Hypertension Diuretics and Antihypertensive Medications (Short Video) Clinical Uses of Diuretics Adverse Effects of Diuretic Drugs Diuretics and Management of Calcium Metabolism Disorders Thiazides and Management of Nephrogenic Diabetes Insipidus Central (Cranial) Diabetes Insipidus Management of Inappropriate Secretion of Antidiuretic Hormone Lithium and Diabetes Insipidus Return to top of Page  Pharmacology Practice Questions:  Diuretic Drugs Practice question set #1 (Osmotic Diuretics) (8 multiple choice questions (mcq) Practice question set #2 (Carbonic Anhydrase Inhibitors I) (7 mcq) Practice question set #3 (Loop Diuretics) (8 mcq) Practice question set #4 (Diuretic Classes) (25 mcq) Practice question set #5 (Diuretic Introduction; Carbonic Anhydrase Inhibitors II) (10 mcq) Practice question set #6 (Carbonic Anhydrase Inhibitors III) (10 mcq) Practice question set #7 (Carbonic Anhydrase Inhibitors IV) (10 mcq) Practice question set #8 (Sodium-Glucose Co-Transporter 2 Inhibitors (e.g. Canagliflozin (Invokana)) (10 mcq) Practice question set #9 (Osmotic Diuretics I e.g. Mannitol) (10 mcq) Practice question set #10 (Osmotic Diuretics II) (10 mcq) Practice question set #11 (Vasopressin (ADH); Diabetes Insipidus) (10 mcq) Practice question set #12 (Sites of action of Diuretic Agents) (10 mcq) Practice question set #13 (Loop of Henle Diuretics I, e.g. furosemide) (8 mcq) Practice question set #14 (Loop Diuretics II e.g. furosemide) (10 mcq) Practice question set #15 (Loop Diuretics III) (10 mcq) Practice question set #16 (Loop Diuretic Clinical Uses; Adverse Effects) (10 mcq) Practice question set #17 (Thiazide and Thiazide-Like Drug Is:  Classification and Site of Action) (10 mcq) Practice question set #18 (Thiazide Diuretics II) (10 mcq) Practice question set #19 (Thiazide Diuretics III) (10 mcq) Practice question set #20 (Potassium-Sparing Diuretics I e.g. Amiloride, Triamterene) (10 mcq) Practice question set #21 (Potassium-Sparing Diuretics II) (10 mcq) Practice question set #22 (Mineralocorticoid Receptor Antagonists (e.g. spironolactone) (10 mcq) Practice exam #1 (19 mcq) Practice exam #2 (36 mcq)   Chapter 27:  Pharmacology of Gastrointestinal Drugs Overview Classification of peptic ulcers Gastric Physiology Gastric Mucosa-Acid Secretion Oxidative phosphorylation Regulation of Gastric Acid Secretion Gastrin-stimulatory Vagal effects-stimulatory Role of histamine Parietal Cell Membrane Receptors Physiological Stumulants of Gastric Acid Secretion Food Cephalic Gastric Intestinal Physiological Inhibition of Gastric Acid Secretion Factors Somatostatin Effects Role of pepsin in peptic ulcer disease Pathogenic Factors Helicobacter Pylorii H. Pylorii Management: Clinical Efficacy Other Pathogenic Factors Involvement in Carcinogenesis Drug Treatment Helicobacter pylorii Bismuth Triple Therapy Drawbacks of Triple Therapy Antacids H2 Receptor Antagonists Anticholinergic Drugs Coating Agents Sucralfate Colloidal Bismuth Prostaglandins Proton Pump Inhibitors Important GI Drugs:  Listing Other GI Drugs  Gastrokinetic Agents Antacids (used as preoperative medication) Antiemetic Drugs Return to top of Page  Pharmacology Practice Questions:  Gastrointestinal Drugs Practice question set #1 (Peptic Ulcer Disease Overview) (15 multiple choice questions (mcq)) Practice question set #2 (Proton Pump Inhibitors I, e.g. lansoprazole) (10 mcq) Practice question set #3 (Proton Pump Inhibitors II) (10 mcq) Practice question set #4 (Proton Pump Inhibitors III) (10 mcq) Practice question set #5 (Proton Pump Inhibitors IV:  Clinical Correlations) (10 mcq) Practice question set #6 (Antacids; H2 Receptor Antagonists I) (8 mcq) Practice question set #7 (H2 Receptor Antagonists II) (10 mcq) Practice question set #8 (H2 Receptor Antagonists III) (10 mcq) Practice question set #9 (Mucosal Protective Agents I: e.g. Misoprostol; Bismuth) (10 mcq) Practice question set #10 (Mucosal Protective Agents II:  Sucralfate) (10 mcq) Practice question set #11 (Mucosal Protective Agents III) (5 mcq) Practice question set #12  (Prokinetic Drugs I) (8 mcq) Practice question set #13  (Prokinetic Drugs II:  Dopamine Systems, Metoclopramide) (10 mcq) Practice question set #14 (Prokinetic Drugs III: Therapeutic Uses and Side Effects) (10 mcq) Practice question set #15 (Prokinetic Drugs IV:  Domperidone, Cisapride I, Tegaserod; Serotonin System) (10 mcq) Practice question set #16 (Prokinetic Drugs V:  Cisapride II; Prucalopride) (10 mcq) Practice question set #17 (Laxatives: Bulk Forming Agents) (10 mcq) Practice question set #18 (Laxatives:  Osmotically-Active Preparations I) (10 mcq) Practice question set #19 (Laxatives:  Osmotically-Active Agents II; Stool Softeners) (8 mcq) Practice question set #20 (Laxatives:  Stimulants I) (10 mcq) Practice question set #21 (Laxatives:  Stimulants II) (8 mcq) Practice question set #22 (Agents that Enhance Cl- Secretion) (10 mcq) Practice question set #23 (Management of Opioid-Induced Constipation I) (9 mcq) Practice question set #24 (Management of Opioid-Induced Constipation II) (10 mcq) Practice question set #25 (Management of Opioid-Induced Constipation III) (10 mcq) Practice question set #26 (Antidiarrheal Drugs) (10 mcq) Practice question set #27 (Antidiarrheal Agents; Bismuth, Probiotics) (9 mcq) Practice question set #28 (Antidiarrheal Agents:  Opioids I) (10 mcq) Practice question set #29 (Antidiarrheal Agents:  Opioids II, including Enkephalins) (10 mcq) Practice question set #30 (Antidiarrheal Agents:  Clonidine, Octreotide I) (10 mcq) Practice question set #31 (Antidiarrheal Agents:  Octreotide II, Telotristat Ethyl) (7 mcq) Practice question set #32 (Antidiarrheal Agents:  Bile-Salt Binding Resins, e.g. cholestipol; Crofelemer) (10 mcq) Practice question set #33 (Irritable Bowel Syndrome (IBS):  Introduction) (10 mcq) Practice question set #34 (Irritable Bowel Syndrome (IBS):  Alosetron; Eluxadoline) (10 mcq) Practice question set #35 (Irritable Bowel Syndrome (IBS):  Anti-cholinergic Drugs; Rifaximin) (10 mcq) Practice question set #36 (Antinauseants and Antiemetics:  5-HT3 Receptor Antagonists I) (10 mcq) Practice question set #37 (Antinauseants and Antiemetics:  5-HT3 Receptor Antagonists II, Clinical Uses, Adverse Effects) (10 mcq) Practice question set #38 (Antinauseants and Antiemetics:  Dopamine Receptor Blockers I:  Phenothiazines; Olanzapine) (10 mcq) Practice question set #39 (Antinauseants and Antiemetics:  Histamine H1 Receptor Antagonists) (10 mcq) Practice question set #40 (Antinauseants and Antiemetics:  Neurokinin 1 (NK1) Antagonists (10 mcq) Practice question set #41 (Antinauseants and Antiemitics:  Dronabinol; Nabilone) (12 mcq) Practice question set #42 (Inflammatory Bowel Disease:  Overview) (10 mcq) Practice question set #43 (Inflammatory Bowel Disease:  Mesalamine (5-aminosalicylic acid)-based agents I) (10 mcq) Practice question set #44 (Inflammatory Bowel Disease: 5-ASA and Related drugs II) (10 mcq) Practice question set #45 (Inflammatory Bowel Disease; Drugs Options and IBD Severity; Corticosteroids) (10 mcq) Practice question set #46 (Inflammatory Bowel Disease:  Azathioprine, Mercaptopurine) (10 mcq) Practice question set #47 (Inflammatory Bowel Disease:  Methotrexate) (13 mcq) Practice question set #48 (Inflammatory Bowel Disease:  Cyclosporine) (10 mcq) Practice question set #49 (Inflammatory Bowel Disease:  Anti-TNF-α Monoclonal Antibodies) (11 mcq) Flashcards set #1 Flashcards set #2 Practice exam #1 (20 mcq) Practice exam #2 (19 mcq) Practice exam #3 (19 mcq) Case #1 (2 mcq) Case #2 (3 mcq)  GI Videos H. pylori and cancer I (25 min) H. pylori and cancer II (31 min)   Chapter 28: Adrenocorticosteroid Pharmacology: Adrenocorticosteroids and Adrenocortical Antagonists Overview Natural Adrenocortical Hormones Clinical uses Control over Adrenocorticoid Secretion Adrenocorticosteroids Major Categories of Action Glucocorticoids Pharmacokinetics Synthesis Characteristics Cortisol metabolism Pharmacodynamics Mechanism of action Receptor Properties Receptor activation sequence Physiological Effects Metabolic Effects Overview Hepatic Effects Adipocytes Fasting State Catabolic Effects Anti-inflammatory/Immunosupression Effects Other Effects Return to top of Page Synthetic Adrenocorticosteroids Pharmacokinetics Pharmacodynamics Clinical Pharmacology Altered Adrenal Function: Diagnosis and Treatment Primary Adrenocortical Insufficiency (Addison's Disease) Overview Etiology/Pathogenesis Adrenal Gland Destruction AIDS Tuberculosis Idiopathic Atrophy Presenting Signs and Symptoms Asthenia Hyperpigmentation Arterial hypotension Gastrointestinal disturbance Primary Adrenocortical insufficiency: Laboratory Findings and Diagnostic Testing Laboratory findings Diagnosis Glucocorticoid Reserve Test Treatment of Primary Adrenocortical Deficiency (Addison's Disease) Replacement Therapy Cortisol: Therapeutic Mainstay Mineralocorticoid component:  Fludrocortisone Special Considerations Acute Adrenocortical Insufficiency Most Frequent Cause Prognosis Prevention Treatment Return to top of Page Adrenocortical Hyperfunction Congenital Adrenal Hyperplasia Most Common Deficiency Decrease or Lack of Cytochrome P450c22 Increased Compensatory ACTH Physiological Consequences 11-hydroxylation Defects 17-hydroxylation Defects Treatment Cushing's Syndrome Primary Cause Short Video Primary Non-iatrogenic cause Incidence Manifestations Short-term Treatment Patient Management Diagnosis/Dexamethasone Suppression Testing Primary Aldosteronism Overview Most common cause Other Causes Physiological Effects: Aldosterone Hypersecretion Diagnosis Clinical Presentation Treatment: Surgery / Aldosterone antagonists Secondary Aldosteronism Cause Associations Pregnancy Hypertension Renal tumors Physiological characteristics Return to top of Page Adrenocorticosteroids in Treatment of Nonadrenal Disorders Adrenocortical Steroids and Fetal Lung Maturation Glucocorticoid Toxicity Metabolic Effects Iatrogenic Cushing's syndrome Other effects Adrenal Suppression Precautions Contraindications ACTH use Corticosteroid dosage forms Mineralocorticoids Aldosterone Desoxycorticosterone Fludrocortisone Adrenal Androgens Antagonists of Adrenocortical Function Metyrapone Aminoglutethimide Ketoconazole Mifepristone (RU-486) Mineralocorticoid Antagonists Spironolactone Return to top of Page  Pharmacology Practice Questions:  Adrenocorticosteroid Pharmacology Practice question set #1 (Natural and Synthetic Corticosteroids) (18 multiple choice questions (mcq)) Practice question set #2 (Adrenal Insufficiency) (20 mcq) Practice question set #3 (Adrenocorticosteroid Pharmacology(10 mcq) Return to top of Page  Adrenocorticosteroid Videos Pituitary Tumor Roundtable I  (6 min) Pituitary Tumor Roundable II  (6 min) Return to top of Page

Chapter 29:  Pharmacological Management of Diabetes Islets of Langerhans Pancreatic Islet Alpha Cell Stimulation Pancreatic Islet Beta Cell Stimulation Diabetes:  Effects of Insulin Deficiency Diabetes mellitus Type I Type II Properties of Type I Diabetes Catabolic Disorder Possible Causes Autoimmune Mechanism Pancreatic Beta-Cell Destruction Immune-Directed Pancreatic Beta-Cell destruction Overview of Clinical Presentation: Type I Diabetes Type 1 diabetes: Sam's story--patient perspective Onset Symptoms secondary to hyperglycemia Acute metabolic decompensation Causes of diabetic ketoacidosis Clinical manifestations of ketoacidosis Diagnosis of ketoacidosis Treatment of ketoacidosis Treatment response Outcome Properties of IDDM and NIDDM Return to top of Page Late Complications of Diabetes Circulatory Abnormalities Retinopathy Nephropathy Treatment Foot Ulcers Autonomic Dysfunction Properties of Type II Diabetes Pathophysiological Phases Clinical Presentations Presenting Syndrome Syndrome properties Prognosis Treatment of Hyperosmolar States Type II Diabetes Treatment Overview Insulin Overview Insulin:  Two Chains Insulin Synthetic Pathway Secretion Proposed Mechanism Insulin Degradation Insulin Receptor Composition Insulin Receptor Ectodomain Monomeric, dimeric forms and combinations Activation Altered affinity Return to top of Page Target Sites Glucose Transporters GLUT 4 Table Summary : Endocrine Effects of Insulin on Liver, Muscle, and Adipose Tissue  Liver Hepatic Insulin Actions Mechanisms for insulin-hepatic actions "Fed" state repression of gluconeogenic enzymes Other hepatic effects Muscle Adipose Tissue Insulin Preparations Four principle types Insulin modifications Subcutaneous insulin therapy Ultra-short acting Short-acting Clinical Use Intermediate-and long-acting insulin NPH insulin Insulin mixtures Insulin Species Beef and pork insulins Human insulins Human proinsulin Delivery systems Insulin Treatment: Overview Glycemic Control Complications of insulin treatment Hypoglycemia Autonomic hyperactivity Treatment Insulin: Immunopathology Return to top of Page Oral hypoglycemics: Categories Sulfonylureas Table of Soulfonylureas Tolbutamide (Orinase) Chlorpropamide (Diabinese) Tolazamide (Tolinase) Acetohexamide Second Generation Sulfonylureas Glyburide (Micronase, DiaBeta) Glipizide Glucotrol) Glimepiride (Amaryl) Secondary Failure and Tachyphylaxis to Sulfonylureas Combination of sulfonylureas and insulin Biguanides Metformin (Glucophage) Proposed Mechanism of Action Clinical Use Toxic/Adverse Effects Contraindications Alpha-glucosidase Inhibitor Acarbose Adverse Effects Thiazolidinedione Derivatives Troglitazone (Rezulin) (withdrawn from market!) Mechanism of Action Clinical Effectiveness Rosiglitazone (Avandia) Glucagon Overview Pharmacological Activity Consequences Cardiovascular Smooth Muscle Glucagon-clinical use Glucagon adverse effects Return to top of Page  Pharmacology Practice Questions:  Anti-Diabetic Drugs Practice question set #1 (Diabetes Overview I) (20 multiple choice questions (mcq)) Practice question set #2 (Complications of Insulin Administration; Insulin Release Inhibitors) (10 mcq) Practice question set #3 (Diabetes Management: Drug Classes; Drug Side Effects) (20 mcq) Practice question set #4 (Diabetes Overview II) (10 mcq) Practice question set #5 (Diabetes Overview III) (10 mcq) Practice question set #6 (Diabetes Overview IV) (10 mcq) Practice question set #7 (Diabetes Overview V) (10 mcq) Practice question set #8 (Insulin I) (10 mcq) Practice question set #9 (Insulin II) (10 mcq) Practice questions set #10 (Adverse insulin effects; Diabetic ketoacidosis) (10 mcq) Practice questions set #11 (Therapeutic Objectives, Management, Background) (10 mcq) Practice question set #12 (Insulin III) (13 mcq) Practice question set #13 (Insulin in Type 1 and Type 2) (10 mcq) Practice question set #14 (Type 1 Diabetes:  Insulin and Adjunct Agents) (10 mcq) Practice question set #15 (Type 2 Diabetes: Monotherapy and Combination Therapy) (10 mcq) Practice question set #16 (Type 2 Diabetes:  Empagliflozin) (10 mcq) Practice question set #17 (Type 2 Diabetes:  Sodium-glucose cotransporter 2 (SGLT2) inhibitors in Renal and Cardiovascular Disease) (8 mcq) Practice question set #18 (Type 2 Diabetes:  Children and Adolescents and General questions)  (8 mcq) Practice question set #19 (Type 2 Diabetes:  Sulfonylureas I) (10 mcq) Practice question set #20 (Type 2 Diabetes:  Sulfonylureas II) (10 mcq) Practice question set #21 (Type 2 Diabetes:  Repaglinide (Prandin) (14 mcq) Practice question set #22 (Type 2 Diabetes:  Nateglinide (Starix) (11 mcq) Practice question set #23 (Type 2 Diabetes:  Metformin (Glucophage and others) (14 mcq) Practice question set #24 (Type 2 Diabetes:  (Thiozolidinediones:  Pioglitazone (Actos) and Rosiglitazone (Avandia) (13 mcq) Practice question set #25 (Type 2 Diabetes: (GLP-1 Introduction I) (10 mcq) Practice question set #26 (Type 2 Diabetes: GLP-1 drug:  Exenatide (Byetta) (13 mcq) Practice question set #27 (Type 2 Diabetes:  GLP-1 drug:  Liragultide (Victoza) (14 mcq) Practice question set #28 (Type 2 Diabetes:  GLP-1 drug:  Dulaglutide (Trulicity) (9 mcq) Practice question set #29 (Type 2 Diabetes:   GLP-1 drug:  Lixisenatide (Adlyxin) (12 mcq) Return to top of Page  Diabetes Management Video Sam's Story  (6 min) Type 2 Diabetes: Treatment I (9 min) Type 2 Diabetes:  Treatment II (78 min) Return to top of Page   Chapter 30:  Pharmacological Management of Thyroid Disorder Thyroid Localization and Anatomy Histological Section Thyroid Physiology Overview Thyroid System Overview Thyroid Hormone Synthesis Receptors TSH receptors (TSH-R) TSH-R: localization and properties Iodide Metabolism Iodide Intake Non-Physiological Thyroid Stimulation Thyroid Hormones Pharmacokinetics Factors altering clearance Mechanisms of Action Metabolic Effects Thyroid Hormonal Effects Thyroid Preparations Preparation of Choice-Synthetic levothyroxine Anti-Thyroid Drugs Overview Classes Thioamides: Major drugs for thyrotoxicosis Propylthiouracil Methimazole Anion Inhibitors Iodides Iodinated Radiographic Contrast Agents Radioactive Iodine Adrenoceptor Antagonists Return to top of Page Hypothyroidism Overview Cretinism Myxedema Classification Pathogenesis Causes Clinical Presentation Neonates Young Children Older Child Adult Advanced Disease Laboratory Tests Pharmacological Treatment Synthetic Hormones Neonatal, infantile, and juvenile hypothyroidism Adults Thyrotoxicosis Definition Most important causes Causes Clinical Presentation Common Manifestations Ocular Cardiovascular Graves' disease Major Presentations Thyroid Pathology Other organ involvement Opthalmopathy Dermopathy Clinical Presentations Thyroid Storm Thyroid Cancer Overview (Video) Return to top of Page  Pharmacology Practice Questions:  Thyroid Drugs  Practice question set #1 Thyroid Hormones; Clinical Considerations  (20 mcq) Practice question set #2 Hypothyroidism Part 1 (10 mcq) Practice question set #3 Hypothyroidism Part 2  (10 mcq) Practice question set #4 Hyperthyroidism  (10 mcq) Practice question set #5 Hyperthyroidism Treatment  (10 mcq) Practice question set #6 L-Thyroxine  (10 mcq) Practice question set #7 Liothyroinine (T3)  (6 mcq) Practice question set #8 Thyrotoxicosis  (10 mcq) Practice question set #9 Methimazole (Tapazole, generics)  (10 mcq) Practice question set #10 Thiouracil, Methimazole  (10 mcq) Practice question set #11 Hyperthyroidism in Pregnancy, Iodides, Adjuvant Drugs  (10 mcq) Practice exam  #1 (10 mcq)  Thyroid Drug Video Thyroid Cancer (5 min) Return to top of Page   Chapter 31:  Gonadal/Ovarian Physiology and Pharmacology Return to top of Page Classification Introduction Ovarian Function Gonadal Activity Stages Puberty: mechanisms leading to ovarian function Onset: Role of Neuronal Maturation One Year Later The Cycle Menopause Anomalies in Ovarian Function Gonadal/gonad1.htm#Minor disturbances Common causes of chronic abnormalities Return to top of Page Estrogens Gonadal/gonad1.htm#Some Commonly Used Estrogens Estrogen Biosynthesis/Metabolism Estrogenic activity Natural estrogens Anatomical site of estrogen synthesis Sources of natural estrogen Synthetic estrogen Pharmacokinetics Conversion steps Biliary excretion Physiological Effects Mechanism: Sequence Estrogen receptors Estrogen-Estrogen-Receptor Complex Hormone Action Genomic Effects Membrane Estrogen Receptors Female Maturation Stimulation-Development Endometrial Effects Metabolic Effects Plasma Lipid Effects Blood Coagulation Estrogen: Clinical Uses Primary Hypogonadism Treatment Post-menopausal hormonal therapy Osteoporosis Bone: Estrogen replacement Cardiovascular Issue Hot flushes Atrophic vaginitis Cancer Alternatives to estrogen therapy Miscellaneous Uses Estrogens: Adverse Effects Diethylstilbesterol Estrogens: Contraindications Progestins Progestational Compounds Progesterone Synthesis Synthetic progestins I Pharmacokinetics Hepatic metabolism Physiological Mechanisms Progesterone Effects: Metabolic Other Progesterone Effects Synthetic progestins II Clinical Uses Therapeutic Uses Diagnostic Uses Other Ovarian Hormones Testosterone Inhibin and Activin Relaxin Return to top of Page Hormonal Contraception Two types of preparations Implants Norgestrel Medroxyprogesterone Pharmacological Effects Ovarian Effects Uterine Effects Effects on the Breast CNS Effects Endocrine Effects Effects on Blood Hepatic Effects Effects on Lipid Metabolism Effects on Carbohydrate Metabolism Cardiovascular Effects Skin Clinical Uses Oral contraception Endometriosis Dysmenorrhea Adverse Effects Introduction Mild Adverse Effects Moderate Adverse Effects Severe Adverse Effects Venous Thromboembolism Myocardial Infarction Cerebrovascular Disease Gastrointestinal Disorder Depression Cancer Return to top of Page Contraceptive: Contraindications/Cautions Progestin monotherapy Depot injection DMPA Progestin implants (L-Norgestrel) Postcoital Contraceptives Beneficial Effects: Oral Contraceptives Estrogen/Progesterone Inhibitors and Antagonists Tamoxifen Breast Cancer Stage I Stage II Stage III Stage IV Clomiphene Mifepristone (RU-486) Use Danazol Clinical Uses Adverse Effects Cautious Use Contraindications Other Ovarian Inhibitors Anastrozole Letrozole/Fadrozole Ovulation-Inducing Drugs Clomiphene Pharmacological Effects Clinical Uses Adverse Effects Contraindications Return to top of Page Testes Overview Testes -- gametogenic/endocrine functions Androgen/Anabolic Steroids Introduction Metabolism Physiological Effects Changes at puberty Metabolic effects: testosterone Synthetic Steroids possessing Androgenic and Metabolic Activity Oral Parenteral Testosterone and Testosterone-Derivatives--Uses Androgens: Replacement Therapy Pharmacological Actions Clinical Uses Androgen Replacement Gynecological Applications Protein: Anabolic Anemias Osteoporosis Growth Abuse: Sports Adverse Effects Contraindications Androgen Suppression and Antiandrogens Androgen Suppression Antiandrogens Leuprolide acetate Goserelin Ketoconazole Conversion Inhibitors Finasteride Receptor Inhibitors Cyproterone and cyproterone acetate Flutamide Bicalutamide Spironolactone Return to top of Page  Pharmacology Practice Questions:  Gonadal Pharmacology Practice question set #1 (Ovarian Structure and Function; Estrogen Secretion) (15 multiple choice questions (mcq)) Practice question set #2 (Management of Gonadal Abnormalities, e.g. Primary Hypogonadism) (15 mcq) Practice question set #3 (Oral Contraception) (10 mcq) Practice question set #4 (Gonadal Pharmacology (10 mcq) Practice question set #5 (BPH; Prostatic Carcinoma; Progesterone, etc.) (10 mcq) Flashcards set #1 Flashcards set #2 Flashcards set #3 Practice Exam #1 (23 mcq) Return to top of Page   Chapter 32:  Hypothalamic Physiology and Pharmacology Introductory Short Video Overview Master Gland Anatomy Pituitary Hormones Video Overview Growth Hormone Prolactin Luteinizing Hormone Thyroid Stimulating Hormone Adrenocorticotropin Vasopressin Oxytocin Feedback Relationships Gonadal Adrenal cortex Thyroid Pituitary Control: Hypothalamus Secretion Control Pituitary and Hypothalamic Hormones Physiological Consequence of Pituitary Tumors Hypothalamic disease Return to top of Page Anatomy: Pituitary Anatomy: Hypothalamus Mechanisms of Hormone Action Overview GHRH, Somatostatin, PRH, TSH, CRH, ACTH, GnRH, FSH, LH, and Dopamine receptors Growth hormone and Prolactin receptors GHRH and GHRPs Overview Chemistry, Pharmacokinetics, and Pharmacodynamics:  GHRH and GHRP Clinical Use Toxicity Return to top of Page Somatostatin Overview Octreotide Overview Clinical Use Adverse Effects Growth Hormone Overview Regulation Chemistry Pharmacokinetics Pharmacological Effects Deficiency Adverse Effects Impaired response Thyrotropin-Releasing Hormone (Protirelin, TRH) Overview Chemistry/Pharmacokinetics Pharmacodynamics Pituitary Tumors Return to top of Page Thyroid-Stimulating Hormone (Thyrotropin, TSH) Overview Chemistry Pharmacokinetics Pharmacodynamics Clinical Use Corticotropin-Releasing Hormone (CRH) Overview Pharmacokinetics Pharmacodynamics Adrenocorticotropin (ACTH) Overview Chemistry Pharmacokinetics Pharmacodynamics Clinical Use Gonadotropin-Releasing Hormone (GnRH., luteinizing hormone-releasing hormone (LHRH);Gonadorelin) Overview Chemistry Pharmacokinetics Pharmacodynamics Clinical Uses Diagnostic Applications Therapeutic Applications Toxicity Return to top of Page Follicle-Stimulating Hormone (FSH) Overview Function Modified FSH molecules Leutinizing-Hormone Gonadotropins (hMG, Menotropins and FSH, Urofollitropin) Overview Pharmacokinetics Pharmacodynamics Clinical Uses Toxcities Other Effects Contraindications Human Chorionic Gonadotropin (hCG) Overview Function Pharmacokinetics Pharmacodynamics Clincial Uses Diagnostic Therapeutic Toxicity Contraindications Prolactin Structure Function Abnormal Levels Deficiency Excess Bromocriptine and Other Dopamine Agonists Overview Mechanism of Action Effects on Other Hormones Clinical Uses Adverse Effects Posterior Pituitary Hormones Overview Oxytocin Chemistry Pharmacokinetics Pharmacodynamics Clinical Uses Toxicity Contraindications Vasopressin Pharmacokinetics Pharmacodynamics Clinical Use Toxicity Return to top of Page  Pharmacology Practice Questions:  Hypothalamic Pharmacology Practice question set #1 (General Questions) (11 multiple choice questions (mcq)) Practice question set #2 (Thyrotropin-Releasing Hormone)  (10 mcq) Practice question set #3 (Hypothalamic Pharmacology:  (10 mcq) Flashcards set #1 Flashcards set #2 Flashcards set #3 Flashcards set #4 Practice exam #1 (10 mcq) Return to top of Page  Hypothalamic Videos What is the pituitary gland? (2 min) Pituitary Hormones I and Growth Hormone (41 min) Pituitary Hormones II (16 min) Prolactinomas  (2 min) Return to top of Page   Chapter 33-34:  Cancer Chemotherapy Chemotherapy Overview Cell Cycle Specific and Non-Specific:  Chemotherapy Drug Classification Cytotoxic Drugs:  Alkylating Drugs and Platinum-Based Agents Alkylating Agents Introduction and Therapeutic Uses Classification Alkyl Sulfonates Busulfan (Busulfex) High-Dose in Stem Cell Conditionning Use in Chronic Myelogenous Leukemia (CML) Ethyleneimes/Methylmelamines Altretamine (Hexalen) Thiotepa Mechlorethamine Nitrogen Mustards Cyclophosphamide (Cytoxan) Use in Ewing Sarcoma Ifosphamide (Ifex) Melphalan (Evomela) Chlorambucil (Leukeran) Nitrosoureas Carmustine (BiCNU, Gliadel wafer) and Lomustine Individual Treatments for Glioblastoma (video) Streptozocin (Zanosar) (a.k.a. Steptozotocin) Non-Classical Alkylating Drugs Bendamustine (Treanda) Procarbazine (Matulane) Dacarbazine (DTIC) Temozolomide (Temodar) Drug Resistance Platinum Analogs Cisplatin Celebration:  40th Anniversary video Introduction Mechanism of Action Cisplatin (Platinol) Cisplatin Hearing Loss in Children (Video) Carboplatin (Paraplatin) Oxaliplatin (Eloxatin) Cytotoxic Drugs:  Antimetabolites Antimetabolites Antifolates:  Methotrexate I Methotrexate II Clinical Uses Pemetrexed (Alimta) Pralatrexate (Fotolyn) Pyrimidine Analogues Cytidine vs. Capecitabine (Xeloda) and 5-Azacytidine (Vidaza) Structure Guanine and 6-Mercaptopurine (Purixan) Structure Thymine and 5-Fluorouracil (Adrucil) Structure Adenine, Cladribine (Leustatin) and Fludarabine (Fludara) Structures 5-fluorouracil (Adrucil) Introduction Absorption, Distribution, Biotransformation, Excretion Resistance to 5-FU Toxicity Clinical Uses Floxuridine Intrahepatic Administration for Liver Carcinoma Short Video:  New method of delivering chemotherapy to the liver for colorectal cancer Capecitabine (Xeloda) Introduction Absorption Excretion Clinical Uses Video:  Capecitabine in Metastatic ER+ Breast Cancer Toxicity Cytidine Analogues Cytarabine (Ara-C) Introduction Cytotoxic Mechanisms Absorption, Distribution, Excretion Clinical Uses Toxicity Video:  Acute Myeloid Leukemia Overview Video:  Acute Myeloid Leukemia Treatment  Azacitidine (Vidaza), decitabine (Dacogen) Introduction Myelodysplastic Syndrome Mechanism of Action Gemcitabine (Gemzar) Overview Drug Activation Mechanism of Action Cell Entry Cytotoxicity Absorption, Distribution, Biotransformation, Excretion Drug Resistance Toxicity Purine Analogues 6-Mercaptopurine Overview Drug Activation History Mechanism of Drug Action Absorption, Distribution, Biotransformation, Excretion Mechanisms of Drug Resistance Toxicity Fludarabine (Fludara) Overview Video: Overcoming the Shortfalls of Ibrutinib with Fludarabine in CLL Patients Mechanism of Drug Action Absorption, Distribution, Biotransformation, Excretion Toxicity Cladribine (Leustatin, Mavenclad) Overview Mechanism of Drug Action Absorption, Distribution, Biotransformation, Excretion Toxicity Clofarabine (Clolar) Overview Mechanism of action Absorption, Distribution, Biotransformation, Excretion Toxicity Nelarabine (Arranon) Overview Videos:  Currents Uses in Acute Lymphoblastic Leukemia Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Toxicity Clinical Uses Pentostatin (Nipent) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicity Natural Products Anti-Microtubule Drugs Microtubules Overview Microtubule Function Vinca Alkaloids Differences Between Vinca Alkaloids Semisynthetic Vinca Alkaloid Derivatives Resistance to the antineoplastic actions of vinca alkaloid drugs Vinblastine (Velban,VBL) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Drug Action Clinical Uses Toxicities Vincristine (Oncovin, Vincasar, VCR) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Drug Action Clinical Uses Toxicities Vinorelbine (Nevelbine) Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities Estramustine Phosphate (Emcyt) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Drug Action Clinical Use Toxicities Epothilones Ixabepilone (Ixempra) Clinical Use Toxicity Drug Elimination Maytansinoids and Auristatins Maytansine Mechanism of Action  Clinical Use and Toxicity  Aurastatins Clinical Uses Toxicities Taxanes Overview Taxanes and Paclitaxel Mechanism of Action Clinical Uses Overview:  Docetaxel Overview:  Carbazetaxel Paclitaxel (Taxol) Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities Nab-Paclitaxel  (Abraxane) Overview Summary Docetaxel (Docefrez, Taxotere) Overview Pharmacokinetics and Metabolism Clinical Uses (Example) Non-Small Cell Lung Cancer (NSCLC) Video:  Adjuvant Treatment in NSCLC Toxicity Carbazitaxel (Jetana) Overview Pharmacokinetics and Metabolism Toxicity Topoisomerase Inhibitors Overview Classification and Actions Camptothecins:  Irinotecan and topotecan Irinotecan Overview Adsorption, Pharmacokinetics, Metabolism, Excretion Adverse/Toxic Effects Mechanism of Drug Action Drug Resistance Clinical Uses Topotecan (Hycamtin) Overview Absorption, Distribution, Metabolism, Excretion Absorption Metabolism Mechanism of Drug Action Adverse/Toxic Effects Drug Resistance Clinical Uses Anthracyclines:  Doxorubicin (Adriamycin) and Related Drugs Overview Absorption, Distribution, Biotransformation, Excretion Toxicity/Adverse Effects Dexrazoxane (Totect) Some Clinical Uses Pegylated Liposomal Doxorubicin Overview Pharmacokinetics and toxicities Daunorubicin (Cerubidine) Overview Absorption, Distribution, Biotransformation, Excretion Toxicity/Adverse Effects Clinical Uses Epirubicin (Ellence) Overview Absorption Distribution, Biotransformation, Excretion Toxicity Idarubicin (Idamycin) Overview Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicity Valrubicin (Valstar) Overview Anthracenedione Derivative Mitoxantrone Professor C.C. Cheng Overview Absorption, Distribution, Biotransformation, Excretion Toxicity Clinical Uses Epipodophyllotoxins Etoposide (VP-16, Etopophos, Toposar) Overview Absorption, Distribution, Biotransformation, Excretion Toxicities Clinical Uses Teniposide (Vumon) Overview Absorption, Distribution, Biotransformation, Excretion Toxicities Clinical Uses Miscellaneous Anticancer Drugs Bleomycin  (Blenoxane) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities L-Asparaginase (Elspar) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities Mitotane (Lysodren) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities Dactinomycin (actinomycin D; Cosmegen) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Toxicities Mitomycin (Mitomycin C, Mitosol) Overview Mechanism of Action Absorption, Distribution, Biotransformation, Excretion Clinical Uses Anal Cancer (video) Metastatic Bladder Cancer (video) Toxicities Hormonal Drugs Introduction Breast Cancer and Hormonal Therapy (video) Glucocorticoids Estrogens Estrogen and Related Agents:  Structures Prototype Structures Hormonal Agents Used in Preventing or Treating Cancers:  Introduction and Structures Selective Estrogen Modulators (SERMs) Tamoxifen (Nolvadex, Soltamox) Overview Absorption, Distribution, Biotransformation, Excretion Side Effects Toremifene (Fareston) Overview Absorption, Distribution, Biotransformation, Excretion Side Effects Raloxifene (Evista, Optruma) Overview Absorption, Distribution, Biotransformation, Excretion Adverse Effects and Warnings Pure Antiestrogens (Selective Estrogen Receptor Downregulators, SERDS) Overview Fulvestrant (Faslodex, others) Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Side Effects/Adverse Effects Aromatase Inhibitors Anastrozole (Arimidex) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Adverse Effects/Toxicities Letrozole (Femara) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action CDK 4/6, Cyclin Clinical Uses Adverse Effects.Toxicities Exemestane (Aromasin) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Adverse Effects/Toxicities Luteinizing hormone releasing hormone agonist (LHRH) Goserelin (Zoladex and Others) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Adverse Effects/Toxicities Leuprolide (Lupron) Overview Absorption, Distribution, Biotransformation, Excretion Clinical Uses Adverse Effects/Toxicities Triptorelin (Decapeptyl, Gonapeptyl, Trelstar (pamolate formulation)) Overview Absorption, Distribution, Biotransformation, Excretion Clinical Uses Adverse Effects/Toxicities Gonadotropin-releasing hormone (GnRH) antagonist Overview Degarelix (Firmagon) Overivew Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Adverse Effects/Toxicities Antiandrogen Drugs Flutamide Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Use Some Adverse Effects/Toxicities Bicalutamide (Casodex) Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Use Some Adverse Effects/Toxicities Nilutamide (Nilandron, Anadron) Absorption Biotransformation Excretion Side effects Abiraterone: Cytochrome P450 enzyme, CYP17 inhibitor: Overview Absorption, Distribution, Biotransformation, Excretion Mechanism of Action Clinical Uses Some Adverse Effects/Toxicities Androgen receptor "superantagonist" Enzalutamide (Xtandi) Targeted Anticancer Drugs Overview Return to top of Page  Pharmacology Practice Questions:  Anticancer Drugs Practice question set #1 (Alkylating Anticancer Drugs I) (13 multiple choice questions (mcq)) Practice question set #2 (Methotrexate (Trexall); 5-FU (Adrucil); I; 6-Mercaptopurine (Purixan)) (6 mcq) Practice question set #3 (Anti-Microtubule Anticancer Drugs I) (6 mcq) Practice question set #4 (Antracycline-type Anticancer Agents I) (6 mcq) Practice question set #5 (Anticancer Drug General Principles) (25 mcq) Practice question set #6 (Cisplatin (Platinol)  I; Anticancer Drug Side Effects) (25 mcq) Practice question set #7 (Dacarbazine (DTIC); Mechlorethamine (Valchlor,Mustargen); Carmustine (BiCNU) ) (10 mcq) Practice question set #8 (Alkylating Agents II) (10 mcq) Practice question set #9 (Alkylating Agents III) (10 mcq) Practice question set #10 (Alkylating Agents IV) (10 mcq) Practice question set #11 (Chlorambucil (Leukeran); Ifosfamide (Ifex); Cyclophosphamide (Cytoxan)) (10 mcq) Practice question set #12 (Cisplatin (Platinol) II; Oxaliplatin (Eloxatin); Carboplatin (Paraplatin)) (10 mcq) Practice question set #13 (Cisplatin (Platinol) and Related Drugs III) (10 mcq) Practice question set #14 (Antifolate Drug Class; Methotrexate (Trexall))(10 mcq) Practice question set #15 (Therapeutic Uses of Specific Anticancer Agents) Practice question set #16 (Methotrexate (Trexall; Cladribine (Leustatin)) (10 mcq) Practice question set #17 (5-FU (Adrucil) II; Pemetrexed) (10 mcq) Practice question set #18 (Therapeutic Uses of Specific Anticancer Agents II) (10 mcq) Practice question set #19 (Cytarabine I (Ara-C) ; Methotrexate (Trexall))  (10 mcq) Practice question set #20 (Cytarabine II (Ara-C) ) (10 mcq) Practice question set #21 (Gemcitabine (Gemzar) ) (10 mcq) Practice question set #22 (Thiopurines; 6-Mercaptopurine (6-MP)) (10 mcq) Practice question set #23 (Fludarabine (Fludara ) (10 mcq) Practice question set #24 (Cladribine (Leustatin) ) (10 mcq) Practice question set #25 (Clofarabine (Clolar); Pentostatin (Nipent); Nelarabine (Arranon)) (10 mcq) Practice question set #26 (Vinblastine (Velban)) (10 mcq) Practice question set #27 (Anticancer Vinca Alkaloids I; Anti-Microtubule II) (10 mcq) Practice question set #28 (Anticancer Vinca Alkaloids II; Maytasinoids; Auristatins; Estramustine (Emcyt)) (10 mcq) Practice question set #29 (Paclitaxel (Abraxane) Docetaxel (Taxotere, Docefrez); Anti-Microtubule III) (10 mcq) Practice question set #30 (Camtothecin-Based Anticancer Drugs; Topotecan (Hycamtin); I Irinotecan (Camptosar, Onivyde) I) (10 mcq) Practice question set #31 (Topotecan II; Irinotecan II; Etoposide (Toposar, Etopophos)) (10 mcq) Practice question set #32 (Dacinomycin (Cosmegen)) (10 mcq) Practice question set #33 (Antracycline Anti-Cancer Agents II) (10 mcq) Practice question set #34 (Epirubicin (Ellence); Valrubicin (Valstar); Doxorubicin (Adriamnycin, Rubex); Daunorubicin (Cerubidine, daunomyucin)) (10 mcq) Practice question set #35 (L-Asparaginase (Elspar, Kidrolase)) (10 mcq) Practice question set #36 (Bleomycin (Blenoxane)) (10 mcq) Practice question set #37 (Mitomycin (Mitosol, Mutamycin)) (10 mcq) Practice question set #38 (Mitotane (Lysodren)) (10 mcq) Practice question set #39 (Trabectedin (Yondelis)) (10 mcq) Practice question set #40 (Hydroxyurea) (10 mcq) Practice question set #41 (Retinoids (Tretinoin (Refissa et al.)) (11 mcq) Practice question set #42 Targeted Therapeutics (10 mcq) Practice question set #43 (Erlotinib (Tarceva):  EGFR Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #43 (Gefitinib (Irissa):  EGFR Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #44 (Afatinib (Gilotrif); EGFR Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #45 (Lapatinib (Tukysa):  EGFR and HER2 Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #46 (Vandetanib (Caprelsa):  EGFR, VEGFR, RET and SRC Tyrosine Kinase Inhibitor) (11 mcq) Practice question set #47 (Neratinib (Nerlynx):  EGFR and HER1, HER2, HER4 Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #48 (Osimertinib (Tagrisso): EGFR (T790M mutant) Tyrosine Kinase Inhibitor) (10 mcq) Practice question set #49 (Sunitinib (Sutent); Inhibitor of VEGFR2 and other Kinases) (10 mcq) Practice question set #50 (Lenvatinib (Lenvima); Inhibitor of VEGFR1,2,3; FGFR, PDGFRα, KIT and RET Kinases) (10 mcq) Practice question set #51 (Cabozantinib (Cabometyx):  Inhibitor of VEGFR2 and numerous other Kinases) (10 mcq) Practice question set #52 (Pazopanib (Votrient); Inhibitor of VEGFR1,2,3 and numerous other Kinases) (10 mcq) Practice question set #52 (Axitinib (Inlyta):  Inhibitor of VEGFR1,2,3) (10 mcq) Practice question set #53 (Regorafinib (Stivarga):  Inhibitor of VEGFR and numerous other Kinases) (10 mcq) Practice question set #54 (Panitumumbab (Vectibix):  Antibody inihibitor of  epidermal growth factor binding to its receptor (EGFR)) (10 mcq) Practice question set #54 (Trastuzumab (Herceptin):  Recombinant humanized monoclonal antibody that binds to the HER2 protein). (10 mcq) Practice question set #55 (Pertuzumab (Perjeta) Recombinant humanized monoclonal antibody that binds to the HER2 protein). (10 mcq) Practice question set #56 (Vismodegib (Erivedge) Hedgehog Pathway Inhibitor) (10 mcq) Practice questionset  #57 (Vemurafenib (Zelboraf):  Raf-kinase Inhibitor; Melanoma) (10 mcq) Practice questionset #58 (Dabrafenib (Tafinlar): Raf-kinase Inhibitor; Trametinib co-administered.) (10 mcq) Practice questionset #59 (Trametinib (Mekinist); Cobimetinib (Cotellic) MEK kinase inhibitors) (10 mcq) Practice questionset #60: (Palbociclib (Ibrance), (Ribociclib (Kisquali), Abemaciclib (Verzenio) :  Inhibitors of Cyclin Dependent Kinases4/6:  Palbociclib (Ibrance) (10 mcq) Practice questionset #61:  (Ibrutinib (Imbruvica) Bruton Tyrosine Kinase (BTK) Inhibitor (10 mcq) Practice questionset #62:  (Acalabrutinib (Calquence) Bruton Tyrosine Kinase (BTK) inhibitor (10 mcq) Practice questionset #63: (Imatinib, Dasatinib, Nilotinib) BCR-ABL Kinase Fusion Gene Inhibitors I (10 mcq) Return to top of Page  Anticancer Videos Chemotherapeutics Agents (16 min) Alkylating agents in treating Neuroendocrine Pancreatic Tumors (8 min) Alkylating Drugs in Cancer Chemotherapy:  Mechanisms of Action (58 min) Stem Cell Tranplantation in Cancer Management (33 min) Imatinib and Targeted Cancer Therapy (34 min) Ovarian Cancer Discussion and Overview (61 min) Ovarian Cancer Treatment (74 min) Breast Cancer:  Treating Metastatic Disease (6 min) Cutaneous T-cell Lymphoma Treatment (3 min) Cell Cycle Specific and Nonspecific Anticancer Drugs (14 min) Cyclophosphamide an Alkylating Anticancer drug (6 min) Alkylating Anticancer Drugs including Nitrogen Mustards, Thio-TEPA, Busulfan, Nitrosoureas, Dacarbazine, Procarbazine (13 min) Anti-Neutrophil Cytoplasmic Antibody and Vasculitis (role of cyclophosphamide in therapy) (24 min) Small Round Blue Cell Tumors (Ewing Sarcoma, Lymphoma (80 min) Noah's Journey with Ewing Sarcoma (7 min) Multiple Myeloma (newly diagnosed):  Daratumumab Comparend to Standard Care (2 min) Melphalan in Treating Myeloma:  Mutagenesis and Melphalan (3 min) Obinutuzumab/chlorambucil versus rituximab in chronic lymphocytic leukemia treatment (6 min) Drugs for treating CLL:  Managing Adverse Drug Effects (23 min) "Obinutuzumab plus bendamustine in rituximab-refractory indolent non-Hodgkin lymphoma" (8 min) Carmustine (Gliadel wafer): "Targeted Treatments in Brain Surgery, Radiation, and Chemotherapy" (57 min) Temozomide and Gliolastoma:  An Introduction (5 min) Temozomide Resistance in Glioblastoma Therapy (78 min) Neuroendocrine Cancer Treatments (30 min) Neuroendocrine Tumors (8 min) Cisplatin and Cancer Chemotherapy:  A Retrospective (37 min) "Cisplatin - 40 Years of Cures with Michigan State University (7 min) Cisplatin:  Cell entry using the human copper transporter (8 min) Carboplatin in Combination Therapy for Non-Small Cell Lung Cancer (NSCLS) (3 min) Neurotoxicity and Adjuvant Oxaliplatin Chemotherapy (2 min) Combining Oxaliplatin and 5-FU in Treating Colon (Cancer while Limiting Neuropathic Adverse Effects) (5 min) Methotrexate Pharmacokinetics (11 min) Methotrexate Toxcities (12 min) Leukemia:  Background and Overview (11 min) Historical View:  Targeting Childhood Leukemia (14 min) Lung Cancer:  Maintenance Drug Approaches (7 min) Tyrosine Kinase Inhibitors (TKI) + Chemotherapy (e.g. Pemetrexed) in NSCLC (EGFR+) (6 min) T-Cell Lymphoma Treatment (4 min) T-Cell Lymphoma: Overview and Treatment Approaches (62 min) T-Cell Lymphoma Differential Diagnosis and CD30 Therapy (3 min) Leucovorin Rescue in Managing Mucositis Due to Pralatrexate (8 min) Hepatic Chemotherapy:  Delivery Methods (37 min) 5-Fluorouracil and Capecitabine:  Early-Onset Toxicities (15 min) Role of Capecitabine in ER+ Metastatic Breast Cancer (3 min) Acute Myeloid Leukemia - Diagnosis and Treatment (2020) (80 min) Acute Myeloid Leukemia (18 min) Acute Myeloid Leukemia Treatment (2013) (9 min) Myelodysplastic Syndrome:  Personalized Therapy (54 min) Pancreatic Cancer:  Review and New Directions (62 min) Gemcitabine Transport And Drug Responses (8 min) Gertrude Elion:  Synthesis of 6-Mercaptopurine (5 min) Chronic Lymphocytic Leukemia (CLL):  Therapy and Clonal Evolution (2016) (3  min) Ibrutinib with Fludabine in CLL: Issues (6 min) Hairy Cell Leukemia (22 min) New Drugs for Relapsed Acute Lymphoblastic Leukemia (ALL) (25 min) Nelarabine:  Role in Treating T-Cell Cancers (2 min) Combination Chemotherapy:  Newly Diagnosed T-cell Acute Lymphoblastic Leukemia or T-cell Lymphoblastic Lymphoma (4 min) Vinorelbine (Navelbine) (15 min) Foot Drop: Neuropathy and Long-Term Use of Vinca Alkaloid Anticancer Drugs (0.5 min) Ataxia: Neuropathy and Extended Use of Vinca Alkaloid Anticancer Drugs (1 min) Gefinitib Compared to Vinorelbin-Cisplatin in NSCLC Adjuvant Treatment (1 min) Ixabepilone and Breast Cancer Management (1 min) Brentuximab Vedotin Pharmacology (1 min) Pacific Yew and Anticancer Taxanes (1 min) Taxus bacata (2 min) Docetaxel in Management of Metastatic Prostate Cancer (6 min) Management:  Castration-Resistant and Advanced Hormone Sensitive Prostate Cancer (26 min) Carbazetaxel in Treating Metastatic Prostate Cancer after Docetaxel (3 min) Paclitaxel Compared to Nab-Paclitaxel (Abraxane annd Ixabepilone (Ixempra) in Managing Breast Cancer (2012) (3 min) Paclitaxel in Treating Ovarian Cancer (3 min) Neutropenia:  Overview (7 min) Hair Loss and Breast Cancer Chemotherapy (2 min) Pembrolizumab (Keytruda):  Breast Cancer Therapy (8 min) Nab-Paclitaxel:  Role in Managing Non-Small Cell Lung Cancer (NSCLC) (10 min) Role of Gemcitabine/Nab-Paclitaxel in Resected Pancreatic Cancer (9 min) Non-Small Cell Lung Cancer (NSCLC):  Adjuvant Therapy (24 min) Anticancer Drug Category:  Topoisomerase I Inhibitors (48 min) Pharmacogenomics of Solid Tumors (2010) (73 min) Liposomal Doxorubicin (16 min) Doxil (First FDA Approved Nano-Drug) (27 min) Antracycline and Cardiotoxicity (31 min) Daunorubicin and Cytarabine for Acute Myelogenous Leukemia (AML):  Liposomal Preparation (6 min) Acute Myelogenous Leukemia (AML):  High-Dose Anthracycline Treatment (6 min) Breast Cancer:  Epirubicin and Cyclophosphamide Prior to Doxcetaxel (3 min) Antracyclines and Gastroesophageal Cancer (6 min) Cardiotoxicity and Anthracyclines (31 min) AML (Newly Diagnosed):  Role for Nivolumab with Cytarabine and Idarubicin (4  min) BCG and Bladder Cancer:  Unresponsive Disease (21 min) Optimal Chemotherapy for Stage III NSCLC? (11 min) Asparaginase (68 min) Anal Cancer (14 min) Metastatic Bladder Cancer:  Immunotherapeutic Approaches (5 min) Breast Cancer:  Hormonal Treatment Approaches (20 min) Selective Estrogen Receptor Modulators and Breast Cancer Prevention (8 min) Tamoxifen and Breast Cancer Treatment Efficacy:  Discoveries (4 min) Comparing Raloxifene to Tamoxifen in Invasive Breast Cancer Prevention (3 min) Fulvestrant and Breast Cancer Treatment (7 min) Fulvestrant +/- Palbobciclib in Management of HER2- Receptor+ Metastatic Breast Cancer (4 min) Extended Aromatase Inhibitors:  Risks and Benefits (6 min) Anastrozole and Breast Cancer in High-Risk Women (6 min) Extended Anastrozole Treatment (5 Years) (15 min) Aromatase Inhibitors:  Side Effects (5 min) Ribociclib and Letrozole in Advanced Breast Cancer Treatment:  Safety and Efficacy (3 min) Everolimus + Exemestane Efficacy in HER2- Breast Cancer (14 min) GNRH:  Antagonists vs. Agonists (6 min) Abiraterone and Prostate Cancer Treatment (2 min) Enzalutamide (Xtandi) and Managing Metastatic Prostate Cancer (5 min) Enzalutamide (Xtandi) and Metastatic Prostate Cancer:  Improved Survival (9 min) Return to top of Page   Chapter 35:  Pharmacology of Antibacterial Agents Antibacterial/antibactobj.htm#Bacterial Cell Wall: Sites of Antibacterial Action Inhibitors of Cell-Wall Synthesis Membrane-Active Agents Inhibitors of Protein Synthesis Inhibitors of Folate-Dependent Pathways   Return to top of Page  Pharmacology Practice Questions:  Antibacterial Drugs Practice question set #1 (General Overview Questions) (19 multiple choice questions (mcq)) Practice question set #2 (Cephalosporins) (19 mcq) Practice question set #3 (Gentamycin, Kanamycin) (15 mcq) Practice question set #4 (Aminoglycosides:  Matching Exercise) Practice question set #5 (Penicillins; Penicillin Resistance) (10 mcq) Practice question set #6 (Pneumonia Treatment) (8 mcq) Practice question set #7 (Tuberculosis Treatment) (20 mcq) Practice question set #8 (Meningitis) (5 mcq) Practice question set #9 (STDs) (15 mcq) Practice question set #10 (Sepsis) (5 mcq) Practice question set #11 (Antibiotic Classes I:  Matching Exercise) Practice question set #12 (Antibiotic Classes II:  Matching Exercise) Practice question set #13 (Urinary Tract Infections (UTI) I) (13 mcq) Practice question set #14 (Sulfonamides) (15 mcq) Practice question set #15 (Sulfonamides:  sulfamethoxazole, sulfisoxazole, sulfadiazine) (10 mcq) Practice question set #16 (Sulfonamides:  Sulfadoxine, Sulfacetamide, Silver sulfadiazine, Mafenide) (10 mcq) Practice question set #17 (Timethoprim/Sulfamethoxazole I (Bactrim DS and others) (10 mcq) Practice question set #18 (Trimethoprim/Sulfamethoxazole II, Fluoroquinolones) (10 mcq) Practice question set #19 (Trimethoprim/Sulfamethoxazole III) (13 mcq) Practice question set #20 (Fluoroquinolones I) 10 (mcq) Practice question set #21 (Fluoroquinolones II) (10 mcq) Practice question set #22 (Fluroquinolones III:  Mechanism of Action (10 mcq) Return to top of Page Practice question set #23 (Fluoroquinolones IV: Antibacterial Spectrum and Resistance (10 mcq) Practice question set #24 (Fluoroquinolones V:  Adverse Effects (8 mcq) Practice question set #25 (Penicillins:  Introduction) (10 mcq) Practice question set #26 (Penicillins: Drug Resistance (10 mcq) Practice question set #27 (Penicillin Pharmacokinetics) (10 mcq) Practice question set #28 (Penicillin Classes and Pharmacological Features I) (6 mcq) Practice question set #29 (ß-lactamase inhibitors; sites of antibiotic actions) (8 mcq) Practice questions set #30 (Drugs of choice for treating specific microbes) (10 mcq) Practice question set #31 (Penicillin pharmacology I) 10 mcq Practice question set #32 (Penicillin pharmacology II (Penicillin G) (10 mcq)  Practice question set #33 (Penicillin pharmacology III (Spectrum of Action I) (10 mcq) Practice question set #34 (Penicillin pharmacology IV (Spectrum of Action II) (10 mcq) Practice question set #35 (Penicillin pharmacology V (Spectrum of Action III) (5 mcq) Practice question set #36 (Penicillin Classes and Pharmacological Features II) (12 mcq) Practice question set #37 (Penicillin Classes and Pharmacological Features III) (10 mcq) Practice question set #38 (Penicillin Classes and Pharmacological Features IV) (11 mcq) Practice question set #39 (Penicillin Hypersensitivity Reactions)  (10 mcq) Practice question set #40 (Cephalosporins I) (10 mcq) Practice question set #41 (Cephalosporins II:  Drug Classifications) (10 mcq) Practice question set #42 (Cephalosporins III:  Drug Classifications (10 mcq) Practice question set #43 (First-Generation Cephalosporins I (11 mcq) Practice question set #44 (First-Generation Cephalosporins II (Clinical Considerations) (10 mcq) Practice question set #45 (Cephalosporin side-effects) (13 mcq) Practice question set #46 (Monobactams:  Aztreonam) (10 mcq) Practice question set #47 (Carbapenems:  Imipenem I (10 mcq) Practice question set #48 (Carbapenems:  Imipenem and others II) (11 mcq) Return to top of Page  Practice question set #49 (Aminoglycosides:  Introduction I) (10 mcq) Practice question set #50 (Aminoglycosides Introduction II) (10 mcq) Practice question set #51 (Aminoglycoside Pharmacokinetics I) (10 mcq) Practice question set #52 (Aminoglycoside Pharmacokinetics II (10 mcq) Practice question set #53 (Aminoglycosides:  Clinical Uses I) (9 mcq) Practice question set #54 (Aminoglycosides:  Clinical Uses II) (10 mcq) Practice question set #55 (Aminoglycosides:  Clinical Uses III) (10 mcq) Practice question set #56 (Streptomycin) (10 mcq) Practice question set #57 (Gentamicin) (10 mcq) Practice question set #58 (Tobramycin) (12 mcq) Practice question set #59 (Amikacin) (10 mcq) Practice question set #60 (Netilmicin) (5mcq)  Practice question set #61 (Spectinomycin (10 mcq) Practice question set #62 (Neomycin) (10 mcq) Practice question set #63 (Paromomycin) (9 mcq) Practice question set #64 (Plazomicin) (6 mcq) Practice question set #65 (Tetracyclines I) (10 mcq) Practice question set #66 (Tetracyclines II)  (10 mcq) Practice question set #67 (Tetracyclines III) (10 mcq) Practice question set #68 (Tetracyclines/Glyclcylines Clincial Uses I (10 mcq) Practice question set #69 (Tetracyclines/Glyclcylines Clincial Uses II (8 mcq) Practice question set #70 (Tetracyclines/Glyclcylines Clincial Uses III (6 mcq)  Practice question set #71 (Tigecycline, Ervacycline, Omadacycline) Return to top of Page Practice question set #72 (Chloramphenicol) (15 mcq) Practice question set #73 (Erythromycin and other macrolide and ketolide drugs I) (10 mcq) Practice question set #74 (Erythromycin and other macrolide and ketolide drugs II) (10 mcq) Practice question set #75 (Erythromycin and other macrolide and ketolide drugs III) (10 mcq) Practice question set #76 (Clarithromycin pharmacokinetics) (10 mcq) Practice question set #77 (Azithromycin and Telithromycin pharmacokinetics) (10 mcq) Practice question set #78 (Drug/drugs of first-choice for some gram-negative and gram-positive cocci) (10 mcq) Practice question set #79 (Drug/drugs of first-choice for some gram-negative rods II) (12 mcq) Practice question set #80 (Drug/drugs of first-choice for some gram-postive rods I (8 mcq)  Practice question set #81 (Drug/drugs of first-choice for acid-fast rods (6 mcq) Practice question set #82 (Drug/drugs of first-choice for Spriochetes (5 mcq) Practice question set #83 (Drug/drugs of first-choice for Mycoplasmas, Chlamydia, Rickettsiae (6 mcq) Practice question set #84 (Lincosamides:  Lincomycin and Clindamycin) (10 mcq) Practice question set #85 (Licosamides:  Clindamycin I (10 mcq) Practice question set #86 (Licosamides:  Clindiamycin II Clinical Uses) (10 mcq) Practice question set #87 (Streptogramins; Quinupristin + Dalfopristin) (10 mcq) Return to top of Page Flashcards Set #1 Flashcards Set #2 Flashcards Set #3 Return to top of Page    Chapter 36:  Pharmacology of Antiviral Drugs: Viral Infections Influenza Viral Replication Steps Anti-herpes Drugs and related topics Acyclovir Mechanism of Action Selectivity Chemistry:  Acyclovir and Valacyclovir Formulations IV Acyclovir in Treating Mucocutaneous Herpes Simplex Virus (HSV) Infections in HIV patients Varicella-Zoster Virus (VZV) Treatment: Introduction Treatment of Genital Herpes Simplex Virus Infections Acyclovir-resistance in HIV:  Foscarnet Varicella-Zoster Virus  (VZV) Infection Acyclovir Summary:  Adverse Effects etc. Ganciclovir (Cytovene, Cymevine) Famciclovir (Famvir) Penciclovir (Denavir) Drug Resistance for Acyclovir and Acyclovir-Related Drugs Cidofovir (Vistide):  Principle of Action Cidofovir Pharmacology Clinical Case:  Intralesion  Cidofovir Treatment Fomivirsen Foscarnet (Foscavir) Kaposi's Sarcoma Trifluridine (Viroptic) Docosonal (Abreva) Idoxuridine (Dendra) Return to top of Page Anti-Influenza Drugs and Related Topics Introduction Complications of Influenza Pneumonia Secondary Bacterial Pneumonia Orthomyxoviruses Influenza Viral Genome Segments Hemagglutinin and Viral Replication Nucleocapsid Release from the Virion Action of the Influenza Antiviral Drug Amantadine Viral RNA Replication Precursor Viral mRNA Capping Amantadine and Rimantadine Introduction Mechanism of Anti-Viral Action Drug Absorption and Elimination Adverse Effects Neuraminidase Inhibitors Short video on Influenza Virus Infection Introduction Oseltamivir and Zanamivir Return to top of Page Anti-HIV Drugs Introduction:  Human Retroviruses Updated Fact Sheet for HIV and Hepatitis C Click Here (8/2021) Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV (March 23, 2023) Click Here (3/2023) Guidelines for the Uses of Antiretroviral Agents in Pediatric HIV Infection (HIV.gov) Click Here (6/2024) HIV/AIDS in 2014: Progress and Priories: Video Presentation Pneumocystics jirovecii Pneumonia Kaposi's Sarcoma Kaposi's Sarcoma:  The Disease (Short Video) Identification of HIV as the Causative Agent in AIDS Retroviral Structure HIV Genome "The History of HIV and Current Epidemic" (video) Return to top of Page Viral Replication Membrane Fusion Reverse Transcription Viral Replication Cycle Viral Integrase Cellular Activation Global HIV/AIDS at the Crossroads:  Where do we go from here (video) HIV Genome Organization HIV and AIDS Etiology Human T-Cell Lymphotropic Viruses (HTLV-I and HTLV-II) Transforming Retroviruses Human Immunodeficiency Viruses (HSV-1 and HIV-2 Phylogenetic Tree of the SIV and HIV viruses HIV-1 Molecular Variability Important Molecules in HIV-1 and molecular therapeutic targets (Video Lecture) Viral Transmission Sexual Transmission Transmission by Blood/Blood Products Mother to Fetal Transmission HIV Among Pregnant Women, Infants, and Children (CDC) HIV-1 Pathophysiology/Pathogenesis Initial Events in HIV Infection HIV-1 Resistance to Antibody Neutralization Long-term Infection:  Latency Phase HIV-Latency:  CD4+ T Cell Reservoir Return to top of Page Symptoms of HIV Disease Introduction Category C:  AIDS Surveillance Case Definition Abbreviated Guidelines for the Prevention of Opportunistic Infections in Persons Infected with HIV Pulmonary Disease PCP Pneumonia Introductory Video I (Backgound/ Biology) Introductory Video II (Prevention/Treatment) Trimethoprim/sulfamethoxazole (TMP/SMX) Bacterial Pneumonia Tuberculosis TB and HIV Co-infection (2012) video Fungal Lung Infections Cryptococcal menningitis (video) Return to top of Page Cardiovascular Disease Cardiomyopathy Anti-HIV-Drug-Induced Myocardial Disease Combination Antiretroviral Treatment HIV Protease Inhibitors Nucleos(t)ide Reverse Transcriptase Inhibitors Effects of Anti-HIV Drugs on Blood Lipids, Glucose and Myocardial Infarction Risk HIV-Associated Electrocardiographic Abnormalities Gastrointestinal Disease Oropharyngeal Esophagitis Intestinal Effects Protozoal Infections Cryptosporidia Microsporidia Isospora belli  Cytomegaloviral colitis (CMV colitis) Algorithm for the diagnosis and management of HIV-associated diarrhea Hepatobiliary Dysfunction Gall Bladder Diseases Liver Disease Hepatitis B Hepatitis C CDC (Centers for Disease Control, USA)  fact sheet:  HIV and Viral Hepatitis Some other infectious hepatic pathogens Hepatotoxicity of Anti-Retroviral Drugs Kidney Disease HIV-Associated Nephropathy (HIVAN) Acute Kidney Injury (AKI) Electrolyte Abnormalities and Possible Causes I Electrolyte Abnormalities and Possible Causes II Antiretroviral Drugs for Treatment of Human Immunodeficiency Viral (HIV) Disease Antiretroviral Drug Classes History and Review HIV Pathogenesis Development of Antiretroviral Drugs Return to top of Page Antiretroviral Drugs Approved in the United States Nucleoside/Nucleotide Reverse Transcriptase Inhibitors (NRTI) table HIV Protease Inhibitor (PI) table Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTI) table Enfurvirtide (Fusion Inhibitor); Maraviroc (CCR5 Inhibitor); Raltegravir (Isentress): table Nucleoside/nucleotide Reverse Transcriptase Inhibitors (Specific Drugs) Zidovudine (AZT) Stavudine (d4T, Zerit) Lamivudine (3TC, Epivir) Abacavir (Ziagen) Mutations and Abacavir Resistance Tenofovir (Viread) Emtricitabine (Emtriva) Didanosine (Videx) Zalcitabine (Hivid) Non-nucleoside Reverse Transcriptase Inhibitors Introduction Nevirapine (Viramune) Efavirenz (Sustiva) Etravirine (Intelence) Delavirdine (Rescriptor) Rilpivirine (Endurant) Integrase Strand Transfer Inhibitors (INSTI) Raltegravir (Isentress) Biomarkers (short video) Elvitegravir (Stribild,Viketa) Stribild (short video) Dolutegravir (Tivicay) Tivicay (short video) Entry Inhibitors Enfuvirtide (Fuzeon) Maraviroc (Selzentry) Protease Inhibitors (Partial Listing) Atazanavir (Reyataz) Darunavir (Prezista) Lopinavir/ritonavir (Kaletra, Aluvia) Return to top of Page Virology Structural and Functional Review Overview and Introduction:  Viral Definition Viral Structure Viral Symmetry Viral Envelopes Viral Structural Proteins Viral Lipids Viral Capsid Assembly Genome Packaging Viral Capsid and Core Proteins Viral Genome Classification Nucleic Acid Strandedness Repetitive Elements 5'-Terminal Cap 5'-Terminal Covalently-Linked Protein Isomerization 3'-Terminal Poly(A) Tract Genomic Organization and Replication Gene Order Open Reading Frames Viral Replication Viral-Cell Membrane Fusion Enfuvirtide (Fuzeon):  Example Drug Enfurvirtide Pharmacology Maraviroc (Selzentry, Celsentri):  Example Drug Miraviroc Pharmacology Viral Gene Expression and Viral Replication Replication of DNA Viral Genomes Baltimore Classification System Return to top of Page Pharmacology Practice Questions:  Antiviral Drugs Practice question set #1 (Viral Structure:  Matching Exercise) Practice question set #2 (Antiviral Drugs:  Fill-in-the-Blank Exercise) Practice question set #3 (HIV and HSV Medications) (10 multiple choice questions (mcq)) Practice question set #4 (HIV Medications; HIV-Associated Infections) (8 mcq) Practice question set #5 (General Anti-Viral Drugs Questions I) (10 mcq) Practice question set #6 (General Anti-Viral Drugs Questions II) (10 mcq) Practice question set #7 (General Anti-Viral Drugs Questions III) (10 mcq) Practice question set #8 (Herpes Anti-Viral Drugs Questions I) (10 mcq) Practice question set #9 (General Anti-Viral Drugs Questions IV) (10 mcq) Practice question set #10 (Acyclovir Questions I) (10 mcq) Practice question set #11 (Acyclovir Questions II) (10 mcq) Practice question set #12 (Acyclovir Questions III; Absorption, Distribution, Biotransformation, Excretion) (10 mcq) Practice question set #13 (Acyclovir Questions IV; Absorption, Distribution, Biotransformation, Excretion) (10 mcq) Return to top of Page Practice question set #14 (Penciclovir (Denavir) Questions I; (10 mcq) Practice question set #15 (Antiviral Drug Prototypes; Ganciclovir (Zirgan) Questions I; (10 mcq) Practice question set #16 (Acyclovir Clinical Uses I) (10 mcq) Practice question set #17 (Acyclovir/valacyclovir Clinical Uses II) (10 mcq) Practice question set #18 (Acyclovir/valacyclovir Clinical Uses III [Genital and Ocular Herpes) (10 mcq) Practice question set #19 (Cidofovir, Valganciclovir, Letermovir I [Cytomegalovirus Infections] (10 mcq) Practice question set #20 (Cidofovir II) (10 mcq) Practice question set #21 (Adverse Drug Effects I) (10 mcq) Practice question set #22 (Letermovir (Prevymis)) (10 mcq) Practice question set #23 (Foscarnet (Foscavir); Nonnucleoside DNA polymerase inhibitor) (10 mcq)  Practice question set #24 (Fomivirsen (Vitravene), Trifluridine (Viroptic), Idoxuridine)  (10 mcq) Practice question set #25 Anti-influenza drugs:  (Amantadine  (Symmetrel and others) and Rimantadine (Flumadine))  (10 mcq) Practice question set #26 Anti-influenza drugs:  (Baloxavir marboxil (Xofluza), Oseltamivir (Tamiflu), Zanamivir (Relenza) and peramivir (Rapivab)  (10 mcq) Practice question set #27 COVID-19 Treatment Part 1A:  Remdesivir (Veklury)  (10 mcq) Practice question set #28 COVID-19 Treatment Part 1B:  Nirmatrelvir in combination with Ritonavir (Paxlovid) (10 mcq) Practice question set #29 HIV Treatment:  Nucleoside and Nucleotide Reverse Transcriptase Inhibitors (10 mcq) Practice question set #30 HIV Treatment:  Nucleoside and Nucleotide Reverse Transcriptase Inhibitors General Questions and Adverse Effects/Toxicities (10 mcq) Practice question set #31 HIV Treatment:  NRTI:  Zidovudine (AZT,  Retrovir) (10 mcq) Practice question set #32 HIV Treatment:  NRTI: Lamivudine (Epivir), Zidovudine (AZT,  Retrovir) (10 mcq) Return to top of Page Practice question set #33 HIV Treatment:  NRTI:  Abacavir (Ziagen) (12 mcq) Practice question set #34 HIV Treatment:  NRTI:  Tenofovir (Viread) (12 mcq) Practice question set #35 HIV Treatment:  NRTI:  Emtricitabine (Emtriva) and related coformulations   (9 mcq) Practice question set #36 HIV Treatment: NRTI:  Didanosine (Videx)  (10 mcq) Practice question set #37 HIV Treatment: NRTI:  SStavudine (Zerit)  (10 mcq) Practice question set #38 HIV Treatment: Nonnucleoside Reverse Transcriptase Inhibitors  (10 mcq) Practice question set #39 HIV Treatment: Nonnucleoside Reverse Transcriptase Inhibitors  (10 mcq)  Practice question set #40 HIV Treatment:  NNRTI:   Nevirapine (Viramune)  (10 mcq) Practice question set #41 HIV Treatment: NNRTI:  Efavirenz (Sustiva) Part 1  (10 mcq) Practice question set #42 HIV Treatment: NNRTI:  Efavirenz (Sustiva) Part 2  (7 mcq) Practice question set #43 HIV Treatment: NNRTI:  Etravirine (Intelence)  (10 mcq) Practice question set #44 HIV Treatment: NNRTI:  Doravirine (Fifeltro)  (10 mcq) Practice question set #45 HIV Treatment: Protease Inhibitors Part 1  (10 mcq) Practice question set #46 HIV Treatment: Protease Inhibitors Part 2  (10 mcq) Practice question set #47 HIV Treatment: Protease Inhibitors:  Ritonavir (Norvir)  (10 mcq) Practice question set #48 HIV Treatment: Protease Inhibitors:  Lopinavir/Ritonavir (Kaletra)  (11 mcq) Practice question set #49 HIV Treatment: Protease Inhibitors:  Atazanavir (Reyataz)  (11 mcq) Practice question set #50 HIV Treatment: Protease Inhibitors:  Darunavir (Prezista)  (11 mcq) Return to top of Page Practice question set #51 HIV Treatment: Entry/Fusion Inhibitors (9 mcq) Practice question set #52 HIV Treatment: Entry/Fusion Inhibitor:  Fostemsavir (Rukobia) (10 mcq)  Practice question set #53 HIV Treatment: Entry/Fusion Inhibitor:  CCR5/Maraviroc (Selzentry) (14 mcq) Practice question set #54 HIV Treatment: Entry/Fusion Inhibitor:  Enfuvirtide (Fuzeon) (12 mcq) Practice question set #55 HIV Treatment: Post-Attachment Inhibitor:  Ibalizumab (Trogarzo)  (10 mcq) Practice question set #56 HIV Treatment: HIV Anti-Retroviral Combination and Coformulations (Flash Cards) Practice question set #57 HIV Treatment:  Capsid Inhibitor:  Lenacapavir (Sunlenca)  (8 mcq) Practice question set #58 HIV Treatment:  Integrase Inhibitor:  Raltegravir (Isentress)  (13 mcq) Practice question set #59 HIV Treatment:  Integrase Inhibitor:  Dolutegravir (Tivicay)  (14 mcq) Practice question set #60 HIV Treatment:  Integrase Inhibitor:  Bictegravir  (Biktarvy)  (10 mcq) Practice question set #61 HIV Treatment:  Integrase Inhibitor:  Cabotegravir (Cabenuva)  (10 mcq)   Practice question set #62 HIV Treatment:  Integrase Inhibitor:  Elvitegravir (Genvoya; Stribild  (8 mcq) Return to top of Page Practice question set #63 Hepatitis C Virus (HCV) Treatment:  Intoduction I:  (10 mcq) Practice question set #64 Hepatitis C Virus (HCV) Treatment:  Intoduction II:  (9 mcq) Practice question set #65 Hepatitis C Virus (HCV) Treatment:  Sofosbuvir (Sovaldi) (10 mcq) Practice question set #66 Hepatitis C Virus (HCV) Treatment:  Sofosbuvir (Sovaldi) and Combinations (9 mcq) Practice question set #67 Hepatitis C Virus (HCV) Treatment:  Sofosbuvir + Velpatasvir or Ledipasvir (9 mcq) Practice question set #68 Hepatitis C Virus (HCV) Treatment:  Sofosbuvir + Voxilaprevir + Velpatasvir  (6 mcq) Practice question set #69 Hepatitis C Virus (HCV) Treatment:  Elbasvir + Grazoprenvir  (10 mcq) Practice question set #70 Hepatitis C Virus (HCV) Treatment:  Simeprevir (Olysio) (8 mcq) Practice question set #71 Hepatitis C Virus (HCV) Treatment:  Glecaprevir + Pibrentasvir (Mayvret)  (11 mcq) Practice question set #72 Hepatitis C Virus (HCV) Treatment:  Ribavirin  (12 mcq) Practice question set #73 Hepatitis B Virus (HBV) Treatment:  Introduction I (9 mcq) Practice question set #74 Hepatitis B Virus (HBV) Treatment:  Introduction II and Drug Adverse Effects  (10 mcq) Practice question set #75 Hepatitis B Virus (HBV) Treatment:  Interferons  (11 mcq) Practice question set #76 Hepatitis B Virus (HBV) Treatment:  Entecavir (Baraclude)  (10 mcq) Practice question set #77 Hepatitis B Virus (HBV) Treatment:  Tenofovir (Viread; Vemlidy)  (10 mcq) Practice question set #78 Hepatitis B Virus (HBV) Treatment:  Adefovir  (10 mcq) Practice question set #79 Hepatitis B Virus (HBV) Treatment:  Lamivudine (Epivir, Epivir HBV)  (10 mcq) Practice question set #80 Hepatitis B Virus (HBV) Treatment:  Telbivudine (Tyzeka (U.S.), Sebivo (E.U.))  (10 mcq) Practice question set #81 Influenza Virus Treatment:  Amantadine (Gocovri), Rimantadine (Flumadine)  (10 mcq) Practice question set #82 Influenza Virus Treatment:  Zanamivir (Relenza), Baloxavir (Xofluza)  (8 mcq) Practice question set #83 Monoclonal Antibody Antivirals:  Palivizumab (Synagis):  Respiratory Syncytial Viral Infections (7 mcq) Practice question set #84 Monoclonal Antibody Antivirals:  Atoltivimab, maftivimab, and odesivimab (Inmazeb) and Ansuvimab (Ebanga): Zaire Ebolavirus Antivirals (8 mcq) Flashcards set #1 Flashcards set #2 Flashcards set #3 Return to top of Page  Antiviral Videos Virus Structure and Replication (14 min) Viral Budding (5 min) HSV Capsid Formation (1 min) Capsid Self-Assembly (2 min) Viral Membrane Fusion (33 min) HIV Binding and Maraviroc Inhibition (5 min) Viral DNA Replication (53 min) Persistent Infections (67 min) Acute Tubular Necrosis (3 min) Ciliated Respiratory Epithelia (1 min) Influenza Hemagglutinin (5 min) Viral mRNA processing (15 min) Influenze Viral Infection (12 min) Tamiflu (Oseltamivir) and Relenza (Zanamivir):  Influenza Antivirals (3 min) Progress in HIV/AIDS (2014) (55 min) HIV Pandemic:  Follow the Science (42 min) Pneumocystis Pneumonia (4 min) Kaposi Sarcoma (23 min) Global HIV/AIDS Issues (90 min) History of Human Immunodeficiency Virus (HIV) (88 min) Molecular of HIV:  Drug Targeting (73 min) "HIV Transmission and Pathogenesis" (8 min) Pneumocystis Pneumonia Part 1 (16 min) Pneumocystis Pneumonia Part 2 (19 min) Tuberculosis and HIV Co-Infection (15 min) Cryptococcal Meningitis (35 min) Cardiovascular Risk Assessment and Antiviral Therapy in HIV (3 min) AIDS Wasting Syndrome (3 min) Normal Endoscopic Retrograde Cholangiopancreatography (ERCP) (7 min) Nucleoside Reverse Transcriptase Resistance (NRTI Resistance) (16 min) NRTI Resistance Mechanisms (1 min) Pharmacogenetics:  Abacavir and Carbamazepine Hypersensitivity (17 min) Tenofovir and Newborn Bone Density (3 min) Nevirapine Binding to HIV-1 Reverse Transcriptase (1 min) Stevens-Johnson Syndrome (54 min) Efavirenz Molecular Modeling (5 min)  NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitors I) (16 min) NNRTI (Non-Nucleoside Reverse Transcriptase Inhibitors II) (12 min) Discovery and Development of HIV-1 Integrase Inhibitors (58 min) HIV Drug Effects on Systemic Inflammation Biomarkers (11 min) Stribild (Combination of Elvitegravir, Cobicistat, Emtricitabine and Tenofovir) (12 min) Dolutegravir:  HIV Integrase Inhibitor (15 min) Maraviroc in Combination Therapies (16 min) Return to top of Page   Chapter 37:  Pharmacology of Antifungal Agents Introduction Mycology Review Classes of Antifungal Drugs: Overview Topical Drugs Imidazoles and triazoles Drugs for cutaneous application Vaginal formulations Polyene Macrolide Antibiotics Other Topicals Return to top of Page Systemic Drugs Griseofulvin Terbinafine (Lamisil) Ketoconazole (Nizoral) Primary Clinical Use Common Toxicities Drug-Drug Interactions Itraconazole (Sporanox) Clinical Use Drug-Drug Interactions Fluconazole (Diflucan) Clinical Use Adverse Effects Pharmacokinetics Drug-Drug Interactions Amphotericin B (Fungizone, Amphotec) Clinical Use Pharmacokinetics Adverse Effects Special Preparations Flucytosine Clinical Use Mechanism of Action Pharmacokinetics Factors increasing incidence and severity of human fungal infections Return to top of Page Treatment of Systemic Infections: Amphotericin B (Fungizone, Amphotec) Pharmacokinetics Mechanism of Action Clinical Use Adverse Effects I.V. Toute of Sdministration Delayed Toxic Reactions Flucytosine (Ancobon) Mechanism of Action Pharmacokinetics Adverse Effects Clinical Uses Azoles Major Advantages Mechanism of Action Clinical Uses Adverse Effects Ketoconazole (Nizoral) Selectivity Clinical Use Itraconazole itraconazole (Sporanox) Clinical Use Fluconazole (Diflucan) Distinguishing Features Clinical Uses Griseofulvin Mechanism of Action Clinical Use Adverse Effects Terbinafine Clinical Use Adverse Effects Nystatin (topical only)a Clinical Use Common Topical Azoles Clinical Uses-Topical Azoles: Topical Allylamines Fungal Infections in HIV Antifungal Drug List Return to top of Page Pharmacology Practice Questions:  Antifungal Drugs  Practice question set #1 (General Antifungal Drug Questions) (10 mcq) Practice question set #2 (Fungi:  Introduction) (10 mcq) Practice question set #3 (Drugs for Treating Some Deep Mycoses) (9 mcq) Practice question set #4 (Drugs for Treating Some Superficial Mycoses:  e.g. candidiasis and ringworm) (9 mcq) Practice question set #5 (Amphotericin B Part 1) (10 mcq) Practice question set #6 (Amphotericin B Part 2) (10 mcq) Practice question set #7 (Amphotericin B Part 3) (10 mcq) Practice question set #8 (Nystatin (Mycostatin)) (5 mcq) Practice question set #9 (Flucytosine (Ancobon)) (10 mcq) Practice question set #10 (Griseofulvin) (10 mcq) Practice question set #11 (Antifungal Agents:  Azoles:  Imidazoles and Triazoles 1 ) (10 mcq) Practice question set #12 (Antifungal Agents:  Azoles:  Imidazoles and Triazoles 2 ) (9 mcq) Practice question set #13 (Antifungal Agents:  Azoles:  Imidazoles and Triazoles 3 ) (9 mcq) Practice question set #14 (Ketoconazole) (10 mcq) Practice question set #15 (Itraconazole (Sporonox)) 1 (9 mcq) Practice question set #16 (Itraconazole (Sporonox)) 2 (10 mcq) Practice question set #17 (Itraconazole (Sporonox)) 3 (Some Clincial Uses) (9 mcq) Return to top of Page Practice question set #18 (Fluconazole (Diflucan)) 1 (10 mcq)  Practice question set #19 (Fluconazole (Diflucan)) 2 (10 mcq) Practice question set #20 (Voriconazole (Vfend) ) 1 (10 mcq) Practice question set #21 (Voriconazole (Vfend) ) 2 (10 mcq) Practice question set #22 (Posaconazole: (Noxafil) ) 1 (10 mcq) Practice question set #23 (Posaconazole: (Noxafil) ) 2 (8 mcq) Practice question set #24 (Isavuconazole (Cresemba)  (10 mcq) Practice question set #25 (Echinocandins I)  (10 mcq) Practice question set #26 (Echinocandins II)  (10 mcq) Practice question set #27 (Echinocandins:  Caspofungin (Cancidas))  (10 mcq) Practice question set #28 (Echinocandins:  Micafungin (Mycamine); Anidulafungin (Eraxis))  (10 mcq) Practice question set #29 Topical Agents  (8 mcq) Practice question set #30 (Topical Agents: Nystatin (Mycostatin))  (10 mcq) Practice question set #31 (Topical Antifungal Agents:  Clotrimazole (Lotrimin), Miconazole (Zeasorb and others))  (10 mcq) Practice question set #32 (Topical Antifungal Agents:  Clotrimazole (Lotrimin)  (7mcq) Practice question set #33 (Topical Antifungal Agents:  Econazole (Ecosza), Efinaconazole (Jublia), Miconazole (Zeasorb))  (10 mcq) Practice question set #34 (Topical Antifungal Agents:  Ciclopirox olamine (Ciclodan) and Tolnaftate  (5 mcq) Flashcard set #1 Return to top of Page  Antifungal Videos Cryptococcal meningitis (35 min) Histoplasmosis (3 min) Return to top of Page   Chapter 38:  Pharmacology of Antiparasitic Drugs Malaria Overview Etiology Diagnosis Clinical Presentations (Subjective) Clinical Presentations (Objective) Clinical Considerations Factors resulting in Fatal Outcomes Parasitic Life Cycle Developmental Stages (human) Interspecies Life Cycle DifferenceS Antimalarial Drug Classification 4-aminoquinolines 8-aminoquinoline Dihydrofolate Reductase [nhibitors Sulfones and Sulfonamides Antibiotics Combinations Site of Drug action and Parasitic Life Cycle Drugs that Prevent Infection Drugs that  Prevent Attacks and Cure Malaria Prophylaxis Treatment: All Species Treatment: Chloroquine-Resistant P. falciparum Return to top of Page Specific Antimalarial Drugs Chloroquine (Aralen) Overview/Pharmacokinetics Dosing Considerations Antimalarial Activity Selective toxicity/Adverse Effects Contraindications Chloroquine (Aralen) Tesistance Clinical Uses: Mefloquine (Lariam) Overview Antimalarial Properties Clinical Uses Adverse Reactions Contraindications Primaquine Antimalarial Properties Clinical Uses Pyrimethamine-proguanil (Chloroguanide) Antimalarial Characteristics Clinical Uses Toxoplasmosis Treatment Adverse Effects Contraindications/Cautions Return to top of Page Sulfonamides and Sulfones Overview: sulfonamides and sulfones Pyrimethamine-sulfadoxine (Fansidar) Quinine (Quinamm) and Quinidine Overview: Quinine (Quinamm) Antimalarial activity Pharmacological Effects Clinical uses Adverse effects Quinidine gluconate (Quinaglute, Quinalan) Return to top of Page Amebiasis Overview Diagnostic criteria Clinical manifestations: subjective Extraintestinal amebiasis Objective clinical manifestations Differential Diagnosis Life-cycle/Laboratory/Microscopy Drugs Used to Treat Amebiasis Chloroquine (Aralen) Emetine (generic) and Dehydroemetine (Mebadin) Diloxanide furoate (Furamide) Iodoquinol (Yodoxin, Moebequin) Metronidazole (Flagyl) in amebiasis and other protozoal infections Paromomycin (Humatin) Leishmania Overview Causal Agents Life Cycle Clinical Characteristics Microscopy Pharmacological management Return to top of Page Pharmacology Practice Questions:  Antiparasitic Agents Practice question set #1 (Parasite Life Cycles) (10 multiple choice questions (mcq)) Practice question set #2 (Falciparum parasite; Malaria Treatment) (20 mcq) Practice question set #3 (Toxoplasmosis: Pyrimethamine; Antimalarial Agents) (15mcq) Practice question set #4 (Trypanosoma) (31 fill-in-the-blank) Practice exam #1 (16 mcq) Practice exam #2 (20 mcq) Flashcard set #1 Return to top of Page   Chapter 39:  Pharmacological Management of Coagulation Disorders Introduction Blood Coagulation: Mechanisms Thrombogenesis: Sequence/Characteristics Injury White Thrombus Red Thrombus Summary: Platelets Blood Coagulation Overview Sequence Cascade Drug Influences Clotting Factors: Drug Clotting Sites Coagulation and Fibrinolysis: Regulation Systems regulating coagulation Inactivation of coagulation proteins Plasma protease inhibitors Failure of plasma protease inhibitor systems Diseminated Intravascular Coagulation (DIC) Fibrolysis Drug interventions: fibrinolytic system: Activators Inhibitors Return to top of Page Anticoagulant Drugs: Pharmacology Heparin Composition Mechanism of Action Bioassay Toxicity Contraindications Reversal of Effect Warfarin/Coumarin Chemistry/Pharmcokinetics Oral Anticoagulation Mechanism of Action Toxicity Miscellaneous Adverse Effects Drug-Drug Interactions Most Serious Interaction: increase anticoagulation Decrease in anticoagulation Pharmacodynamic Effects Reversal of Warfarin anticoagulation Other related Agents Return to top of Page Fibrolytic Drugs Overview Pharmacology Streptokinase Urokinase Anistreplase t-PA Clinical Uses Antithrombotic Agents- Antiplatelet Drugs Overview Regulation of Platelet Function Pharmacological Targets Aspirin Mechanims of Action Clinical Use Adverse Effects Dietary Ticlopidine Clinical Use Adverse Effects Blockade of GP IIb/IIIa Clinical Use Return to top of Page Pharmacological Management of Thrombosis Venous Thrombosis Acquired Disease Antithrombotic Management Prevention Heparin Oral Anticoagulants Venous Thrombosis-established Arterial Thrombosis Platelet-inhibiting agents Clinical Uses Drugs Used in Bleeding Disorders Vitamin K Clinical Issues: Vitamin K Plasma Fractions-- Bleeding due to factor deficiencies Overview Coagulation Defects Factor VIII Desmopressin acetate Factor IX Fibrinogen Fibrinolytic Inhibitors: Aminocaproic Acid Clinical Uses Adverse Effects Return to top of Page Pharmacology Practice Questions:  Drugs that Influence Coagulation Practice question set #1 (General Questions) (10 multiple choice questions (mcq)) Practice question set #2 (Heparin, Enoxaparin, Coumarin Agents) (10 mcq) Practice question set #3 (Heparin Pharmacology) (10 mcq) Practice question set #4 (Fibrolytics) (10 mcq) Flashcard set #1 Practice exam #1 (10 mcq) Return to top of Page   Chapter 40:  Immunopharmacology Introduction Innate Immune System Adaptive Immune System Characteristics Effectors of Humoral Immunity Effectors of Cell-Mediated Immunity Specific Immunity: Requirements Lymphocyte Selection Subsets of T helper lymphocytes TH1 Cell-mediated Immunity TH2 Humoral Immunity T helper lymphocytes: Mutual Regulation Cytotoxic Consequences of Immune System Activation Activated cytotoxic T Cells MHC molecules NK cells: Main Precursor of Lymphokine Dctivated Killer (LAK) Cells B lymphocytes: Humoral Immunity Steps Following Antigen Binding to B-cell Membrane Immunoglobulin (IgM or IgD) Return to top of Page Abnormal Immune Responses Hypersensitivity Immediate hypersensitivity TypeI Characteristics Consequences Type II Characteristics Occurences Consequences Newborn hemolytic disease Prevention Drug-Induced Type III Characteristics Delayed Hypersensitivity Macrophage/Neutrophil Recruitment Autoimmunity Introduction Clinical Pathologic Consequences Rheumatoid arthritis Systemic Lupus Erythrematosis Insulin-Dependent Diabetes Mellitus Possible Explanations for Autoimmune Disease Immunodeficiency Diseases Overview Congenital Immunodeficiency X-linked agammaglobulinemia DiGeorge's syndrome Severe Combined Immunodeficiency Disease (SCID) ADA deficiency Acquired Immunodeficiency: AIDS HIV Immunocompetency Testing Return to top of Page Immunosuppressive Therapy & Cancer Chemotherapy Immunosuppressive Drugs Corticosteroids Lympholytic activity Effects on inflammatory mediators Effects on neutrophils/monocytes leukocyte distribution Cytokine Effects Clinical Uses Autoimmune Disorders Adverse Effects Cyclosporine Pharmacokinetics/Pharmacodynamics Site of Action Inhibition of Gene Transcription Graft-vs-Host Syndrome Adverse Effects/Toxicities Clinical Use Immunosuppression Monotherapy Tacrolimus (FK 506) Mechanism of Action Adverse/Toxic Effects Interferons Families Type I Interferon Effects Clinical Uses New Immunosuppressive Agents Mycophenolate mofetil Possible Clinical Uses Related Drugs of Interest 15-desoxyspergualin Antimonocytic Effects Clinical Uses Sirolimus Mechanism of Action Possible Clinical Uses Thalidomide Clinical Uses Return to top of Page Immunosuppressive Cytotoxic Drugs Azathioprine Chemistry Primary Use Pharmacokinetics/pharmacodynamics Mechanism of Immunosuppression Clinical Use Toxicities Cyclophosphamide Clinical Uses Autoimmune Disorders Adverse effects Vincristine Clinical Use Adverse Effects Vinblastine Clinical Use Adverse Effects Methotrexate (MTX) Mechanism of Action Adverse Effects Clinical Uses Dactinomycin Mechanism of Action Clinical Use Adverse Effects Return to top of Page Antibodies as Immunosuppressive Drugs Overview Antilymphocyte and Antithymocyte Antibodies Organ Transplanation Antilymphocyte Antibodies (ALG) Mechanisms Consequences of Festruction/Inactivation of T cells Transplantation ALG-Adverse Effects Clinical Trials/ Special Uses Immune Globulin Intravenous (IGIV) Clinical Applications Suggested Mechanisms Rho(D) immune globulin micro-dose Prevention of Rh Hemolytic Disease in the Newborn Composition: Rho(D) Immune Globulin Process Leading to Rh Hemolytic Disease in the Newborn Clinical Uses: Immunosuppressive Drugs Overview Three Primary Uses Summary of Clinical Uses of Immunosuppressive Agents Organ Transplantation Tissue Typing HLA Haplotype Dystem MLC system Value: Hood Histocompatibility Primary Renal Disease Factors Important for Transplantation Duccess Bone Marrow Transplantation: Aplastic Anemia Resistant Acute Leukemia SCID (Severe, Combined Immunodeficiency  Syndrome) Cyclosporine Autoimmune Disorders Remissions Improvement Idiopathic Aplastic Anemia Mechanism of Drug Action Return to top of Page Immunomodulating Drugs Rationale Potential Clinical Uses Drugs Thymosin DiGeorge's Syndrome Thymosin Derivatives Cytokines Potential Clinical Uses Interferon (IFN)-alpha Interferon (IFN)-beta Interferon (IFN)-gamma IL-2 Levamisole Roquinimex BCG (Bacille Calmette-Guerin) Other Immune modulators-investigational Cancer Immunotherapy Current Approaches immunotherapeutic agents Current FDA Approved Immunotherapeutic Agents Gene Therapy Purpose Management of Immunologic Disease SCID Approaches for Gene Therapy and Management of Cancer Gene Therapy Purpose Management of Immunologic Disease -- Example: Severe Combined Immunodeficiency Syndrome (SCID) -- ADA deficiency Approaches for Gene Therapy and Management of Cancer Immunologic Reactions to Drugs and Drug Allergy Drugs Causing True Allergic Reactions Allergic Drug Reactions: characteristics Immune-mediated Drug reactions: Different mechanisms: Four types Type I: IgE-Mediated Type II: Complement-dependent Type III: - Serum Sickness Type IV: Cell-mediated allergy Return to top of Page Immediate (Type I) Drug Allergy: Mechanisms Drug = Hapten Acute Allergic Reaction Sequence Drug Treatment Prednisone Reduced Mediator Release Antihistamines Corticosteroids Cromolyn Ketotifen Drug Desensitization Type II Autoimmune Drug Reactions Examples Systemic Lupus Erythematosus "Lupoid Hepatitis" Autoimmune hemolytic anemia Thrombocytopenic purpura Agranulocytosis Serum sickness and Vasculitic (Type III) Reactions Clinical Characteristics Immune Vasculitis Erythema Multiforme Stevens-Johnson Syndrome Return to top of Page Pharmacology Practice Questions:  Drugs that Affect the Immune System: (Immunosuppressants and Immunomodulators) Practice question set #1 (Immune Responses:  General) (15 multiple choice questions (mcq)) Practice question set #2 (Sites of Immunosuppressive Drug Activity) (6 mcq) Practice question set #3 (Immune Suppression; Immunodysfunction) (15 mcq)  Practice question set #4 (Glucocorticoids I) (10 mcq) Practice question set #5 (Glucocorticoids II) (10 mcq) Practice question set #6 (Glucocorticoids III) (10 mcq) Practice question set #7 (Calcineurin Inhibitors I (Cyclosporin, Tacrolimus)) (10 mcq) Practice question set #8 (Calcineurin Inhibitors II (Cyclosporin, Tacrolimus)) (10 mcq) Practice question set #9 (Calcineurin Inhibitors III (Cyclosporin, Tacrolimus)) (10 mcq) Practice question set #10 (Proliferation Signal Inhibitors I (Sirolimus, Everolimus)) (10 mcq) Practice question set #11 (Proliferation Signal Inhibitors II (Sirolimus, Everolimus)) (10 mcq) Practice question set #12 (Mycophenolate mofetil (Myfortic, CellCept)) (10 mcq) Practice question set #13 (Sphingosine-1-phosphate, Fingolimod (Gilenya) I)) (10 mcq) Practice question set #14 (Fingolimod (Gilenya) II) (10 mcq) Practice question set #15 (Siponimod (Mayzent)) (7 mcq) Practice question set #16 (Ozanimod (Zeposia)) (10 mcq) Practice question set #17 (Azathioprine (Imuran)) (9 mcq) Practice question set #18 (Cytotoxic/Antiproliferative Drugs  :  Cyclophosphamide (Cytoxan)) (10 mcq) Practice question set #19 (Folic Acid Antagonist: Methotrexate (Trexall et al.)) (10 mcq)  Practice question set #20 (Monoclonal, Polyclonal Antibodies, Leflunomide (Arava), Teriflunomide, Mitoxantrone (Novantrone), Pentostatin)) (10 mcq) Practice question set #21 ((Antithymocyte globulin (ATG), anti-CD3 monoclonal antibodies (mAbs), Teplizumab (Tzield), Alemtuzumab (Lemtrada)) (10 mcq) Practice question set #22 (anti-IL-2 receptor antibodies (anti-CD25 a.k.a. IL-2Rα)) (10 mcq) Practice question set #23 (Basiliximab (Simulect)) [Treatment: organ rejection prevention]  (8 mcq) Practice question set #24 (Selective Costimulation Inhibitor:  Belatacept (Nulojix)) [Treatment: extending graft/transplant survival]  (10 mcq) Practice question set #25 (Selective Costimulation Inhibitor:  Abatacept (Orencia) [Treatment: rheumatoid arthritis]  (5 mcq) Return to top of Page Practice question set #26 (TNF-α antagonist (Tumor Necrosis Factor α)  Infleximab (Remicade), Etanercept (Enbrel), Adalimumab (Humira), Golimumab (Simponi), Certolizumab (Cimzia)) [Treatment:  may be used to treat psoriatic arthritis, ankylosing spondylitis, plaque psoriasis, juvenile idiopathic arthritis, rheumatoid arthritis, Crohn's disease, ulcerative colitis etc.] (10 mcq) Practice question set #27 (TNF-α antagonist (Tumor Necrosis Factor α)  Infleximab (Remicade))[Treatment:  Crohn's disease, rheumatoid arthritis, ulcerative colitis, psoriatic arthritis, Behcet's disease] (10 mcq) Practice question set #28 (TNF-α antagonist (Tumor Necrosis Factor α)  Etanercept (Enbrel)) [Treatment: rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, juvenile idiopathic arthritis, ankylosing spondylitis] (10 mcq) Practice question set #29 (TNF-α antagonist (Tumor Necrosis Factor α)  Adalimumab (Humira)) [Treatment:  rheumatoid arthritis, psoriatic arthritis, idiopathic arthritis, ankylosing spondylitis, gross disease, ulcerative colitis, plaque psoriasis, hidradentitis suppurativa, uveitis] (10 mcq) Practice question set #30 (TNF-α  antagonist (Tumor Necrosis Factor α)  Golimumab (Simponi))[Treatment: psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis] (9 mcq) Practice question set #31 (TNF-α  antagonist (Tumor Necrosis Factor α)  Certolizumab pegol (Cimzia)) [Treatment: Crohn's disease, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis] (10 mcq) Practice question set #32 (IL-1  antagonist Anakinra (Kineret)[Treatment: rheumatoid arthritis, cryopyrin-associated periodic syndromes, familial Mediterranean fever, Still's disease] (10 mcq) Practice question set #33 (IL-1  antagonist Canakinumab (Ilaris) [Treatment: systemic juvenile idiopathic arthritis, Still's disease, gout flares] (10 mcq)  Practice question set #34 (IL-1  antagonist Rilonacept (Arcalyst) [Treatment: cryopyrin-associated periodic syndromes, Muckle-Wells syndrome] (8 mcq) Practice question set #35 (Interleukin antagonist: Tocilizumab (Actemra) [Treatment: rheumatoid arthritis, systemic juvenile idiopathic arthritis, polyradicular juvenile idiopathic arthritis, giant cell arteritis, cytokine release syndrome], Sarilumab (Kevzara) [Treatment: rheumatoid arthritis], Satralizumab (Enspryng)[Treatment: neural myelitis optica spectrum disorder] (8 mcq) Practice question set #36 (Interleukin antagonists: Guselkumab (Tremfya) [Treatment: severe plaque psoriasis, psoriatic arthritis], Risankizumab (Skyrizi), Tildrakizumab (Ilumya) (10 mcq) Practice question set #37 (IL-17 Cytokine and IL-17 Receptor Inhibitors: Ixekizumab (Taltz) [Treatment: pediatric plaque psoriasis; adult plaque psoriasis; ankylosing spondylitis], Secukinumab (Cosentyx) [Treatment: Psoriatic arthritis, plaque psoriasis, ankylosing spondylitis], and Brodalumab (Siliq) [Treatment: plaque psoriasis] (10 mcq) Practice question set #38 a Human IgG1 Monoclonal Antibody and an IL-36 Inhibitor: Anifrolumab (Saphnelo) [Treatment: systemic lupus erythematosus and Spesolimab (Spevigo) [Treatment: generalized pustular psoriasis]  (10 mcq) Practice question set #39 Natalizumab (Tysabri) for treatment of multiple sclerosis and Crohn's disease  (10 mcq) Practice question set #40 Vendolizumab (Entyvio) for treatment of ulcerative colitis and Crohn's disease  (10 mcq) Return to top of Page Practice question set #41 Caplacizumab (Cablivi) for treatment of acquired thrombotic thrombocytopenic purpura (aTTP)  (6 mcq) Practice question set #42 Crizanlizumab (Adakveo) for  prevention of recurrent vaso-occlusive crises in sickle cell disease patient 16 years old and older. (5 mcq) Practice question set #43 Eptinezumab (VYepti), Erenumab (Aimovig),Fremanezumab (Ajovy), Galcanezumab (Emgality) for preventive treatment of chronic and episodic migraine. (10 mcq)  Practice question set #44 Idarucizumab (Praxbind for the reversal of the anticoagulant action of dabigatran (Pradaxa)  (8 mcq) Practice question set #45 Muromonab Treatment of steroid resistant cardiac, liver, or renal allograft rejection (6 mcq) Practice question set #46 Abciximab (Reopro): antiplatelet drug used in angioplasty (with or without stenting) [percutaneous coronary intervention] (10 mcq) Practice question set #47 Alirocumab (Praluent), Evolocumab (Repatha) Abciximab (Reopro) Evinacumab (Evkeeza) : Drugs that lower LDL levels (7 mcq) Practice question set #48 Denosumab (Prolia):  Bone Anti-Resporptive Agent (6 mcq) Practice question set #49 Eculizumab (Soliris) , Ravulizumab (Ultomiris): Treatment for atypical hemolytic uremic syndrome (aHUS) and paroxysmal nocturnal hemoglobinuria (PNH) (6 mcq) Practice questions set #50 Lanadelumab (Takhzyro): Treatment of Hereditary Angioedema (8 mcq) Practice question set #51 Sutimlimab (Enjaymo) Treatment of cold agglutinin disease (CAD) in adults. (8 mcq) Practice question set #52:  Palivizumab (Synagis) Antiviral Prevention/Treatment for Respiratory Syncytial Virus (RSV) (7 mcq) Practice question set #53:  Atoltivimab, Maftivimab and Odesivimab (Inmazeb) and Ansuvimab (Ebanga) Antiviral Treatment for Ebola Zaire (8 mcq) Practice question set #54:  Obiltoxamimab (Anthim) and Raxibacumab (ABthrax) for Treating Inhalational Exposure to Bacillus anthracis spores (8 mcq) Return to top of Page Practice question set #55:  JAK-STAT signaling pathway (6 mcq) Practice question set #56:  Upadacitinib (Rinvoq) JAK-STAT Inhibitor for treament of  inflammatory disorders such as rheumatoid arthritis  (10 mcq) Practice question set #57:  Ruxolitinib (Jakafi) JAK-STAT Inhibitor used in treating treating myeloproliferative neoplasms (7mcq) Practice question set #58:  Baricitinib (Olumiant) JAK-STAT Inhibitor used in treating alopecial areata, COVID-19, rheumatoid arthritis (10 mcq) Practice question set #59:  Filgotinib (Jyseleca) JAK-STAT Inhibitor used in treating rheumatoid arthritis (9 mcq) Practice question set #60 Pacritinib (Vonjo) JAK2 and IRAK1 Inhibitor used in treating myelofibrosis with moderate to severe thrombocytopenia (8 mcq) Flashcard set #1 Flashcard set #2 Practice exam #1 (13 mcq) Return to top of Page   Chapter 41:  Pharmacology of Anti-inflammatory Drugs Inflammation: Overview Three Phases Acute Inflammation Immune Response Chronic Inflammation Mediators Rheumatoid Arthritis Clinical Characteristics Cellular Damage Released Active Compounds Prostaglandins Cyclooxygenase Isozyme COXII Celecoxib (Celebrex) Leukotrienes Effects Chemotactic Vascular Pulmonary Therapeutic Approaches Goals Pain Relief Drug Categories Return to top of Page Nonsteroidal Antiinflammatory Drugs Aspirin and other Salicylates Shared Properties Chemistry/Pharmacokinetics--aspirin/salicylates Salicylic acid; acetylsalicyclic acid Aspirin Excretion Pharmacodynamics Mechanism of Action Antiinflammatory Effects Analgesic Effects Antipyretic Effects Fever associated with infection Effect on Platelets Clinical Uses Analgesia/Anti-inflammatory Effects Other Clinical Uses Adverse Effects Gastrointestinal Side Effects GI Upset Gastric Bleeding Central Nervous System Other Adverse Effects Aspirin Overdosage Drug-Drug Interactions Nonacetylated Salicylates Drug List Properties Diflusnisal Properties Clinical Uses Return to top of Page Other Nonsteroidal Anti-inflammatory Drugs Overview Chemistry Drug Classes: Examples Pharmacodynamics: NSAIDS Mechanism of Inflammation Reduction:NSAIDs Properties: NSAIDS Pharmacokinetics: NSAIDS Ibuprofen Properties Contraindications Side-Effects Naproxen and Fenoprofen Properties Naproxin Fenoprofen Adverse Effects Flubiprofen Properties Clinical Use Ketoprofen Properties Clinical Use Oxaprozin Properties Diclofenac Properties Clinical Use Sulindac Properties Clinical Use Tolmetin Properties Etodolac Properties Nabumetone Properties Meclofenamate Properties Piroxicam Properties Clinical use NSAIDs: Special Indications Indomethacin Overview Clinical Uses Adverse Effects Cautious Use Phenylbutazone Properties Ketorolac Properties Clinical Pharmacology Issues Prescribing Considerations Return to top of Page Disease Modifying Antirheumatic Drugs (DMARDs) Overview Rheumatoid Arthritis Disease Modifying Antirheumatic Drugs (DMARDs) Immunosuppressive Drugs Toxicities Methotrexate Mechanisms of Action Toxicities Hepatotoxicity Management Antimalarial Drugs: Chloroquine Overview Clinical Indications Gold Overview Chemistry Pharmacokinetics Pharmacodynamics Clinical Uses/Contraindications Major Contraindication Adverse Effects Penicillamine Overview Pharmacokinetics Pharmacodynamics Clinical Indications Adverse Effects Contraindications Glucocorticoids Overview Pharmacodynamics Adverse Effects Clinical Use Diet Acetaminophen Overview Pharmacokinetics Clinical Uses Adverse Effects Return to top of Page Gout Introduction, Disease Definition, Etiology Clinical Manifestation Usual Patient Differential Diagnosis Pharmacological Management Mechanistic Rationale Sequence of Pathophysiological Events Colchicine Overview Pharmacokinetics Pharmacodynamics Mechanism of Action Clinical Indications Adverse Effects NSAIDs Overview Rationale Uricosuric Drugs: Probenecid and Sulfinpyrazone Chemistry Pharmacokinetics Pharmacodynamics Adverse Effects Allopurinol Overview Chemistry Pharmacokinetics Pharmacodynamics Clinical Use/Issues Adverse Effects Drug-Drug Interactions Return to top of Page Pharmacology Practice Questions:  Drugs that Treat Inflammation Practice question set #1 (Inflammatory Mechanisms; Pain Management)  (10 multiple choice questions (mcq)) Practice question set #2 (Acute and Chronic Inflammation (10 mcq) Practice question set #3 (Arthritis; Gout) (10 mcq) Flashcard set #1 Practice exam #1 (23 mcq) Return to top of Page   Special Topics Chapter 42:  Preoperative Evaluation of  Patients for Cardiovascular Disease Chapter 43:  Cardiovascular Systems Review, Adult Cardiac Procedures Flashcards Set 1 Flashcards Set 2 Chapter 44:  Pain Management Chapter 45:  Pulmonary Hypertension Video Lecture:  Dyspnea (42 min) Video Lecture:  Improving Diagnosis (96 min) Video Lecture:  Prognosis and Management of PH (42 min) Chapter 46: CHF:  Congestive Heart Failure Video Lecture:  Management of CHF (20 min) Chapter 47:  Brain Injury: clinical correlation, evaluation and management Chapter 48:  Pulmonary Function in Normal and Pathological States Chapter 49: COPD:  Chronic Obstructive Pulmonary Diseases Chapter 50: Anesthesia in the Asthmatic Patient and Related Issues Return to top of Page

Primary Sources for Information Used in Practice Questions and Content Harrisons's Principles of Internal Medicine, 19th edition and earlier editions (Kasper D Fauci A, Hauser S Longo D Jameson JL and Loscalzo J, eds) 2015;  McGraw-Hill Education. Harrisons's Principles of Internal Medicine, 20th edition and earlier editions (Kasper D Fauci A, Hauser S Longo D Jameson JL and Loscalzo J, eds) 2018;  McGraw-Hill Education. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 13th editions and earlier editions (Brunton LL Hilal-Dandan R Knollmann BC, eds) 2018;  McGraw-Hill Education. Basic & Clinical Pharmacology, 14th edition and earlier editions Katzung BG,  2018; McGraw-Hill Education. Cancer:  Principles & Practice of Oncology 11th edition and earlier edictions (DeVita, Jr VT Lawrence TS Rosenberg SA, eds) 2019; Wolters Kluwer Cancer Chemotherapy, Immunotherapy and Biotherapy Principles and Practice 6th edition, (Chabner BA Longo DL, eds) 2019; Wolters Kluwer Foye's Principles of Medicinal Chemistry 8th Edition (Roche VF Zito SW Lemke TL Williams DA, eds), 2020 Wolters Kluwer Drug Monographs; Access Medicine on-line.

 

• Pharmacology site development  Michael Gordon, Ph.D.

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